Liesbeth Bax, MD, PhD; Willem P.T.M. Mali, MD, PhD; Jaap J. Beutler, MD, PhD
Potential Conflicts of Interest: None disclosed.
Bax L., Mali W., Beutler J.; Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function. Ann Intern Med. 2010;152:198. doi: 10.7326/0003-4819-152-3-201002020-00023
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Published: Ann Intern Med. 2010;152(3):198.
Our study showed that stent placement incurs costs and complications for an at best uncertain benefit in patients with impaired renal function and atherosclerotic renal artery stenosis (ARAS). For these patients, stenting remains a subject of research. We want to emphasize that we focused our study on impaired renal function and ARAS and therefore do not make statements about other categories of patients, such as those with renovascular hypertension, therapy-refractory hypertension, or congestive heart failure.
As discussed in our article, the lower-than-anticipated event rate reduced the power of our study, and we might therefore be dealing with a chance finding. In the meantime, the ASTRAL (Angioplasty and Stenting for Renal Artery Lesions) study (1) from the United Kingdom, which includes more than 800 patients, has found similar results and did not show any effect in predefined subgroup analysis, such as severe renal dysfunction or severe or bilateral renal artery stenosis.
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