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Abstract：
BACKGROUND: The indications, benefits, and outcomes of percutaneous transluminal renal artery intervention (PTRI) remain controversial. The study purpose was to evaluate the long-term outcomes of PTRI in clinical practice.
METHODS: A retrospective review of 217 subjects (254 renal arteries; mean age, 59.8 years) who underwent PTRI based on medical database.
RESULTS: The most common cause of renal artery stenosis was atherosclerosis in 217 (85.4%), followed by Takayasu arteritis (TA) in 23 (9.1%), fibromuscular dysplasia in five (2.0%) and others in nine (3.5%). Mean follow-up duration was 5.7 ± 3.7 years. The first restenosis rate was 7.5% (n = 19; highest in TA: n = 9, 47.4%) and second restenosis occurred in six arteries (five TAs, one fibromuscular dysplasia). Follow-up blood pressure improved from 142.0/83.5 to 122.8/73.5 mmHg (P < 0.001). There was no change within 5 years\' follow-up in estimated glomerular filtration rate (P = 0.44), whereas TA changed from 69.8 ± 20.5 to 84.2 ± 17.9 mL/min/1.73 m² (P = 0.008). Progressive renal dysfunction was related to diabetes mellitus, chronic kidney disease, and peripheral artery obstructive disease on multivariate analysis with hazard ratios (95% confidence intervals) of 2.24 (1.21-4.17), 2.54 (1.33-4.84), and 3.93 (1.97-7.82), respectively.
CONCLUSIONS: PTRI was associated with a blood pressure reduction. Despite a higher rate of restenosis, patients with TA showed significant improvement in estimated glomerular filtration rate. Diabetes mellitus, chronic kidney disease, and peripheral artery obstructive disease were related with progressive renal dysfunction after PTRI.
METHODS: A retrospective review of 217 subjects (254 renal arteries; mean age, 59.8 years) who underwent PTRI based on medical database.
RESULTS: The most common cause of renal artery stenosis was atherosclerosis in 217 (85.4%), followed by Takayasu arteritis (TA) in 23 (9.1%), fibromuscular dysplasia in five (2.0%) and others in nine (3.5%). Mean follow-up duration was 5.7 ± 3.7 years. The first restenosis rate was 7.5% (n = 19; highest in TA: n = 9, 47.4%) and second restenosis occurred in six arteries (five TAs, one fibromuscular dysplasia). Follow-up blood pressure improved from 142.0/83.5 to 122.8/73.5 mmHg (P < 0.001). There was no change within 5 years\' follow-up in estimated glomerular filtration rate (P = 0.44), whereas TA changed from 69.8 ± 20.5 to 84.2 ± 17.9 mL/min/1.73 m² (P = 0.008). Progressive renal dysfunction was related to diabetes mellitus, chronic kidney disease, and peripheral artery obstructive disease on multivariate analysis with hazard ratios (95% confidence intervals) of 2.24 (1.21-4.17), 2.54 (1.33-4.84), and 3.93 (1.97-7.82), respectively.
CONCLUSIONS: PTRI was associated with a blood pressure reduction. Despite a higher rate of restenosis, patients with TA showed significant improvement in estimated glomerular filtration rate. Diabetes mellitus, chronic kidney disease, and peripheral artery obstructive disease were related with progressive renal dysfunction after PTRI.
摘要：
背景：适应症，好处,经皮腔内肾动脉介入治疗(PTRI)的结果仍存在争议.研究目的是评估PTRI在临床实践中的长期结果。
方法：对217名受试者（254条肾动脉；平均年龄，59.8年），根据医学数据库接受PTRI。
结果：肾动脉狭窄的最常见原因是217例（85.4％）的动脉粥样硬化，其次是23例(9.1%)的大动脉炎(TA)，五个（2.0％）和其他九个（3.5％）的纤维肌性发育不良。平均随访时间为5.7±3.7年。第一次再狭窄率为7.5％（n=19；TA最高：n=9，47.4％），第二次再狭窄发生在六个动脉（五个TA，一种纤维肌肉发育不良）。随访血压由142.0/83.5改善至122.8/73.5mmHg(P<0.001)。估计的肾小球滤过率在5年内没有变化（P=0.44），而TA从69.8±20.5变为84.2±17.9mL/min/1.73m²（P=0.008）。进行性肾功能障碍与糖尿病有关，慢性肾病,和外周动脉阻塞性疾病的多变量分析的风险比（95％置信区间）为2.24（1.21-4.17），2.54(1.33-4.84),和3.93（1.97-7.82），分别。
结论：PTRI与血压降低有关。尽管再狭窄率较高,TA患者的估计肾小球滤过率显著改善.糖尿病,慢性肾病,外周动脉阻塞性疾病与PTRI后进行性肾功能不全有关。
方法：对217名受试者（254条肾动脉；平均年龄，59.8年），根据医学数据库接受PTRI。
结果：肾动脉狭窄的最常见原因是217例（85.4％）的动脉粥样硬化，其次是23例(9.1%)的大动脉炎(TA)，五个（2.0％）和其他九个（3.5％）的纤维肌性发育不良。平均随访时间为5.7±3.7年。第一次再狭窄率为7.5％（n=19；TA最高：n=9，47.4％），第二次再狭窄发生在六个动脉（五个TA，一种纤维肌肉发育不良）。随访血压由142.0/83.5改善至122.8/73.5mmHg(P<0.001)。估计的肾小球滤过率在5年内没有变化（P=0.44），而TA从69.8±20.5变为84.2±17.9mL/min/1.73m²（P=0.008）。进行性肾功能障碍与糖尿病有关，慢性肾病,和外周动脉阻塞性疾病的多变量分析的风险比（95％置信区间）为2.24（1.21-4.17），2.54(1.33-4.84),和3.93（1.97-7.82），分别。
结论：PTRI与血压降低有关。尽管再狭窄率较高,TA患者的估计肾小球滤过率显著改善.糖尿病,慢性肾病,外周动脉阻塞性疾病与PTRI后进行性肾功能不全有关。
