Ischemic nephropathy: proteinuria and renal resistance index could suggest if revascularization is recommended

Ren Fail. 2010;32(10):1167-71. doi: 10.3109/0886022X.2010.516856.

Abstract

Background: The aim of endovascular therapy in renal artery stenosis (RAS) is to preserve renal function and have a better hypertension control. The purpose of our study was to determine which biochemical and instrumental parameters could predict a better renal outcome in patients with RAS treated with percutaneous transluminal angioplasty and stenting (RPTAS).

Methods: We performed an observational study based on 40 patients with RAS who met the following criteria before revascularization: urinary protein excretion of over 250 mg/24 h, normal renal function, and/or mild-moderate renal insufficiency (I, II, and III levels of classification of chronic kidney disease, K-DOQI).

Results: Assessment at 12 months after RPTAS showed in 20 patients (Group A) that proteinuria serum creatinine (Scr) and creatinine clearance (CrCl) significantly worsened from the baseline; whereas in 20 patients (Group B) proteinuria remained unchanged and the renal function improved after the procedure.

Conclusions: In our study, the decline of renal function after RPTAS is associated with an elevated renal resistance index (RI) in both kidneys (0.83 ± 0.2) and preexisting proteinuria.

MeSH terms

  • Aged
  • Angioplasty
  • Atherosclerosis / therapy
  • Blood Flow Velocity
  • Creatinine / blood
  • Disease Progression
  • Female
  • Hemorheology
  • Humans
  • Male
  • Middle Aged
  • Proteinuria / complications
  • Proteinuria / surgery
  • Renal Artery Obstruction / complications
  • Renal Artery Obstruction / therapy*
  • Stents

Substances

  • Creatinine