Original Paper

Enhanced Flow Velocity after Stenting of Renal Arteries Is Associated with Decreased Renal Function
Matthias Girndt^a, Harald Kaul^a, Carla Maute^{a, b}, Bernhard Kramann^b, Hans Köhler^a, Michael Uder<sup>c

a</sup>Medical Department IV, and
^bDepartment of Diagnostic Radiology, University of the Saarland, Homburg/Saar, and
^cDepartment of Diagnostic Radiology, University Erlangen-Nürnberg, Erlangen, Germany

Address of Corresponding Author

Nephron Clin Pract 2007;105:c84-c89 (DOI: 10.1159/000097866)

  Key Words

• Angioplasty
• Hypertension, renovascular
• Kidney failure, chronic
• Kidney function tests
• MDRD formula
• Renal artery obstruction
• Ultrasonography Doppler duplex

  Abstract

Background: Atherosclerotic renal artery stenosis (RAS) is frequently treated by angioplasty and stent placement. Duplex sonography is an established noninvasive technique for patient follow-up. There is lack of evidence that routine monitoring of asymptomatic patients with stable blood pressure is needed. Methods: Renal duplex sonography was performed in 64 patients who had received percutaneous angioplasty and stenting of an atherosclerotic RAS. Duplex sonographic diagnosis was made by a combination of direct flow measurement in the renal artery and evaluation of intrarenal resistive indices. Renal function was determined by serum creatinine and calculated glomerular filtration rate (GFR). Results: With a mean follow-up of 28 months after angioplasty, a flow velocity of >2.0 m/s was detected within the stented arteries in 11/64 patients. While the initial blood pressure and GFR as well as the influence of angioplasty on these parameters were not different, the decrease in renal function over time was significantly higher in patients with flow enhancement (annual GFR decrease, 8.0 ml/min vs. 0.8 ml/min; p < 0.05). Conclusion: Follow-up duplex sonography in patients after renal artery stenting detected an unexpectedly high rate of in-stent restenosis associated with enhanced loss of renal function. Routine duplex sonographic follow-up may detect patients at risk of more rapidly declining renal function.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Matthias Girndt, MD
Medical Department IV, Nephrology and Hypertension Unit
University of the Saarland
DE-66421 Homburg/Saar (Germany)
Tel. +49 6841 162 3527, Fax +49 6841 162 3545, E-Mail inmgir@uniklinik-saarland.de

  Article Information

Received: March 22, 2006
Accepted: September 14, 2006
Published online: December 11, 2006
Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 4, Number of References : 20