Miyashita Yusuke, Ikeda Uichi, Soga Yoshimitsu, Yokoi Hiroyoshi, Suzuki Kenji, Inoue Naoto
Department of Advanced Peripheral Artery Disease Therapeutics, Shinshu University Hospital, Matsumoto, Japan
Department of Advanced Peripheral Artery Disease Therapeutics, Shinshu University Hospital, Matsumoto, Japan.
Angiology. 2014 Aug;65(7):620-3. doi: 10.1177/0003319713501069. Epub 2013 Sep 3.
Renal artery stenting is expected to improve or stabilize renal function. However, the efficacy of renal artery stenting in severely reduced renal function is unclear. We evaluated 23 patients with class IV or V renal dysfunction who were treated for renal artery stenosis between 2004 and 2009. Improvement in renal function was found in 7 (30%) patients, all of whom were treated with distal protection device. Deterioration of renal function was found in 4 (17%) cases. In these 4 cases, distal protection device could not be used for anatomical reasons. The use of distal protection device was associated with significantly less renal deterioration after the procedure (P < .05, odds ratio 0.21 [confidence interval 0.09-0.50]). Renal artery stenting can stabilize or improve renal function in patients with severe renal dysfunction. Distal protection devices may be beneficial in patients who require renal artery stenting due to severely reduced renal function.
肾动脉支架置入术有望改善或稳定肾功能。然而，肾动脉支架置入术对严重肾功能减退患者的疗效尚不清楚。我们评估了2004年至2009年间因肾动脉狭窄接受治疗的23例IV级或V级肾功能不全患者。7例（30%）患者肾功能得到改善，所有这些患者均接受了远端保护装置治疗。4例（17%）患者肾功能恶化。在这4例患者中，由于解剖学原因无法使用远端保护装置。使用远端保护装置与术后肾功能恶化显著减少相关（P<0.05，优势比0.21[置信区间0.09-0.50]）。肾动脉支架置入术可稳定或改善严重肾功能不全患者的肾功能。远端保护装置可能对因严重肾功能减退而需要肾动脉支架置入术的患者有益。
