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Kidney Week

Abstract: PO1808

Revascularization in Atherosclerotic Bilateral Renal Artery Stenosis

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Shaikh, Sana J., Washington University in St Louis, St Louis, Missouri, United States
  • Al-Khalil, Bilal, Washington University in St Louis, St Louis, Missouri, United States
  • Chen, Ling, Washington University in St Louis, St Louis, Missouri, United States
  • Vijayan, Anitha, Washington University in St Louis, St Louis, Missouri, United States
Background

Patients with B/L RAS, if found to have worsening renal failure, refractory HTN or recurrent CHF, are often referred for revascularization despite limited evidence. We hypothesized that revascularization plus medical management prevents adverse outcomes in patients with B/L RAS.

Methods

This was a retrospective single-center cohort study in patients with B/L RAS, RAS in a solitary kidney, U/L RAS with an atrophic or >1cm smaller contralateral kidney or, RAS in a U/L functioning kidney. We excluded patients with non-atherosclerotic RAS, renal artery dissection, atheroembolism and renal transplantation.

The primary outcome was Major Adverse Kidney Events (MAKE) at 3 mo. Secondary outcomes were renal events, changes in BP, hospital admissions and all-cause mortality at 1 yr. We used the Chi-square test for the primary outcome and the Chi-square test or two-sample t-tests for the secondary outcomes.

Results

153 patients were included in the study. There were no differences in the baseline characteristics of the intervention and control groups, except for higher number of smokers in the control cohort (Table 1).

There was no difference in MAKE between the 2 groups at 3 mo. At 1 yr, there were fewer admissions for CHF in the intervention group (Table 2). There were no other major differences in secondary outcome measures.

Conclusion

Revascularization for B/L RAS does not improve renal outcomes, BP control or mortality, but may prevent admissions for CHF.