Chang Jae Hyun, Kim Beom Seok, Oh Hyung Jung, Yoo Tae-Hyun, Kang Shin-Wook, Lee Ho Yung, Choi Donghoon, Shim Won-Heum, Choi Kyu Hun
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Scand J Urol Nephrol. 2010 Apr;44(3):169-74. doi: 10.3109/00365591003636570.
Percutaneous transluminal renal artery angioplasty and stenting (PTRAS) is one treatment option for atherosclerotic renal artery stenosis (ARAS). However, factors predicting the outcome remain controversial. This study investigated the effect of the baseline glomerular filtration rate (GFR) on renal function after PTRAS in patients with ARAS.
Patients who underwent PTRAS due to significant ARAS (luminal narrowing > or = 60%) were enrolled. The patients were divided into control (n = 57; estimated GFR (eGFR) > or = 60 ml/min/1.73 m(2)) and chronic renal failure (CRF) groups (n = 53; eGFR < 60 ml/min/1.73 m(2)), according to the baseline eGFR.
The mean age at the time of PTRAS was 62 +/- 9 years, and the mean duration of follow-up was 50 +/- 26 months. There was a significant decrease in eGFR after PTRAS in the control group, whereas the CRF group showed no significant change in eGFR. The percentage change in eGFR was negatively correlated with the baseline eGFR (r = -0.274, p = 0.004). Multivariate linear regression revealed that only baseline eGFR predicted the change in eGFR (p = 0.032).
PTRAS was more effective at preserving renal function in patients with moderately impaired renal function. Thus, baseline GFR may indicate the expected renal function outcome after PTRAS.
经皮腔内肾动脉血管成形术和支架置入术（PTRAS）是治疗动脉粥样硬化性肾动脉狭窄（ARAS）的一种选择。然而，预测其疗效的因素仍存在争议。本研究调查了基线肾小球滤过率（GFR）对ARAS患者PTRAS术后肾功能的影响。
纳入因严重ARAS（管腔狭窄≥60%）而接受PTRAS的患者。根据基线估算肾小球滤过率（eGFR），将患者分为对照组（n = 57；eGFR≥60 ml/min/1.73 m²）和慢性肾衰竭（CRF）组（n = 53；eGFR < 60 ml/min/1.73 m²）。
PTRAS时的平均年龄为62±9岁，平均随访时间为50±26个月。对照组PTRAS术后eGFR显著下降，而CRF组eGFR无显著变化。eGFR的变化百分比与基线eGFR呈负相关（r = -0.274，p = 0.004）。多变量线性回归显示，只有基线eGFR可预测eGFR的变化（p = 0.032）。
PTRAS在保护肾功能中度受损患者的肾功能方面更有效。因此，基线GFR可能预示PTRAS术后的肾功能预期结果。
