Distal embolic protection during renal artery stenting: Impact on hypertensive patients with renal dysfunction

Abstract

Distal embolic protection (DEP) may prevent embolization of atherosclerotic debris during renal artery stenting. The authors retrospectively identified 48 hypertensive patients with chronic kidney disease (CKD) who underwent renal artery stenting between 2002 and 2005 and compared stenting alone (n=17) to stenting/DEP (n = 31). Blood pressure (BP) and estimated glomerular filtration rate (eGFR) (mL/min/ 1.73m 2) at baseline at 6 and 12 months were compared. Overall, eGFR improved by 4.7 (P = .005) at 6months and 3.8 (P = .003) at 12months compared with baseline. Comparing stent to stent/DEP patients, eGFR improvement did not differ at 6months (7.6 vs 2.9; P = .15) or at 12months (4.4 vs 3.5; P = .74). Systolic BP reduction was similar between stent and stent/DEP patients at 6 months (-9 vs -14mm Hg; P = .59) and at 12months (-18 vs -16mm Hg; P = .89). Renal artery stenting improved eGFR and systolic BP in patients with hypertension and CKD; however, DEP did not enhance these effects. © 2008 Le Jacq.