[Long-term follow-up of elderly patients with atherosclerotic renal artery stenosis treated by percutaneous transluminal angioplasty with stent implantation].

OBJECTIVE

To evaluate the long-term effects of percutaneous transluminal renal angioplasty with stent (PTRAS) on hypertension and renal function in elderly patients with atherosclerotic renal artery stenosis (ARAS).

METHODS

The data of elderly ARAS patients as diagnosed by angiography (stenosis ≥ 70%) were retrospectively collected. PTRAS was performed in 65 patients. The average follow-up period was 30.9 months.

RESULTS

There were significant decrease in BP (blood pressure, mm Hg, 1 mm Hg = 0.133 kPa) (before: 154 ± 24/ 79 ± 119 vs after: 132 ± 14/69 ± 8; P < 0.01) at Day 3 post-PTRAS and the decrease of BP continued until 36 months after PTRAS. The average category of antihypertensive medication also decreased from 2.3 ± 1.1 to 2.1 ± 1.0. The incidence of contrast-induced nephropathy (CIN) was 9.2%. Logistic regression analysis showed that the factors of pre-operative diabetes mellitus, GFR ≤ 30 ml×min(-1)·1.73 m(-2), systolic pressure ≥ 180 mm Hg and hydration therapy had a significant relationship with the incidence of CIN (P = 0.0072; OR = 13.51; P = 0.0002; OR = 519.27; P = 0.0134; OR = 13.16 and P = 0.0266; OR = 0.10; respectively). Renal function improved in 9.1%-15.8% of patients, stabilized in 67.3% - 55.3% and deteriorated in 23.4% - 28.9% of patients at Months 12 - 36 post-PTRAS. Logistic regression analysis showed that the diabetics had a higher risk of deteriorating renal function at month 12 post-PTRAS (P = 0.0277; OR = 6.32). The restenosis rate was 13.8%.

CONCLUSION

PTRAS is beneficial in the control of blood pressure in elderly ARAS patients within 36 months after operation. The post-PTRAS improvement of renal function in elderly patients is limited.