Introduction: There are no systematic tools to predict blood pressure (BP) or renal function (RF) improvement after stent‑assisted percutaneous transluminal angioplasty (PTA) for atherosclerotic renal artery stenosis (ARAS).
Objective: This study aimed to develop simple, clinically applicable scores based on preprocedural clinical and renal ultrasonography parameters in order to predict BP and RF improvement following ARAS‑PTA.
Patients and methods: A total of 202 patients who underwent ARAS‑PTA were categorized as RF responders (eGFR increase ≥11 ml/min/1.73 m2) or BP responders (systolic and diastolic BP decrease ≥20 mm Hg and ≥5 mm Hg, respectively) at 12 months following ARAS‑PTA. The variables associated with the RF or BP response in univariable analysis were included in a multivariable logistic regression model. Point‑based response scales were developed proportionally to odds ratios in each of the 2 models to embrace the maximum score of 10.
Results: The BP response to ARAS‑PTA was 93.3% in the high‑probability category (6-10 points), 66.7% in the medium‑probability category (3-5 points), and 25.3% in the low‑probability category (0-2 points), with the preprocedural variables of systolic BP ≥145 mm Hg (3 points), diastolic BP ≥83 mm Hg (4 points), PTA of a single functioning kidney (2 points), and bilateral PTA (1 point). The RF response was 77.3% in the high‑probability category (8-10 points), 33% in the medium‑probability category (4-7 points), and 10.9% in the low‑probability category (0-3 points) for serum creatinine levels >122 μmol/l and eGFR >30 ml/min/1.73 m2 (3 points), index kidney length >98 mm (3 points), renal artery end‑diastolic velocity >1.1 m/s (2 points), and arterial resistive index <0.74 (2 points).
Conclusions: Models of favorable BP and RF response may improve patient selection for ARAS‑PTA. Further insights are expected from prospective validation.