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首页> 外文期刊>Clinical nephrology >Renal artery revascularization in patients with atherosclerotic renal artery stenosis and impaired renal function: conservative management versus renal artery stenting.
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Renal artery revascularization in patients with atherosclerotic renal artery stenosis and impaired renal function: conservative management versus renal artery stenting.

机译：动脉粥样硬化性肾动脉狭窄和肾功能受损的患者的肾动脉血运重建：保守治疗与肾动脉支架置入术。

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BACKGROUND: The impact of percutaneous renal artery angioplasty and stenting (PTRAS) for treatment of atherosclerotic renal artery stenosis (ARAS) is not fully understood, especially in patients with chronic kidney disease (CKD). The goal of this study was to compare renal outcomes in patients treated with PTRAS with those managed conservatively. METHODS: Retrospective cohort study of 118 prevalent patients with significant ARAS and moderate-to-severe CKD who were treated medically (n = 71) or with PTRAS (n = 47). The primary endpoint was change in renal function over the first year after diagnosis/treatment. RESULTS: Average age was 73 +/- 8 years, baseline glomerular filtration rate was 37 +/- 15 ml/min/1.73 m2, and average follow-up was 34 months. Baseline characteristics were similar between the two groups, with the exception of higher diastolic blood pressure in the PTRAS group (75 versus 70 mmHg, p = 0.028). There were no significant differences between the two groups during follow-up. The decline in glomerular filtration rate was similar in both groups (-1.6 ml/min/1.73 m2 in the medical group versus -1.4 ml/min/1.73 m2 in the PTRAS group, p = 0.938). Multivariate models did not indicate an association between treatment modality and changes in renal function or rates of ESRD or death. CONCLUSION: In patients with advanced kidney disease, medical therapy and renal artery stenting appear comparable in stabilizing renal function for ARAS.
机译：背景：经皮肾动脉血管成形术和支架置入术（PTRAS）对动脉粥样硬化性肾动脉狭窄（ARAS）的治疗作用尚未完全了解，尤其是在患有慢性肾脏疾病（CKD）的患者中。这项研究的目的是将接受PTRAS治疗的患者的肾脏结局与保守治疗的患者进行比较。方法：回顾性队列研究对118例患有严重ARAS和中至重度CKD的患者进行了药物治疗（n = 71）或PTRAS（n = 47）。主要终点是诊断/治疗后第一年的肾功能变化。结果：平均年龄为73 +/- 8岁，基线肾小球滤过率为37 +/- 15 ml / min / 1.73 m2，平均随访时间为34个月。两组的基线特征相似，除了PTRAS组的舒张压较高（75 vs 70 mmHg，p = 0.028）。随访期间两组之间无显着差异。两组的肾小球滤过率下降相似（医疗组为-1.6 ml / min / 1.73 m2，而PTRAS组为-1.4 ml / min / 1.73 m2，p = 0.938）。多变量模型未显示治疗方式与肾功能变化或ESRD或死亡率之间存在关联。结论：在晚期肾脏疾病患者中，药物治疗和肾动脉支架置入在稳定ARAS肾功能方面具有可比性。

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