Evaluation of the therapeutic efficacy of renal artery stenting in patients with atherosclerotic renal artery stenosis.

Purpose: It is currently controversial whether renal artery stenting is beneficial for the clinical outcomes of atherosclerotic renal artery stenosis (ARAS) patients. The study aims to evaluate whether blood pressure (BP) and renal function improve in ARAS patients after stenting.

Methods: A retrospective study was conducted on 78 ARAS patients who underwent renal artery stenting at the First Affiliated Hospital of Chongqing Medical University from January 2013 to June 2024. BP, the number of oral antihypertensive medications, renal function, and adverse events were analyzed before and after stenting.

Results: A total of 90 stents were implanted. The median follow-up time was 1.59 years. From 24 hours post-operation, significant decline in BP were observed. During follow-up, systolic BP decreased by 24.27 mmHg (95% CI: 16.54-32.00; < 0.0001) and diastolic BP by 12.27 mmHg (95% CI: 7.25-17.29; < 0.0001), but the reduction in the number of oral antihypertensive medications was not significant (> 0.05). Serum creatinine also showed a significant decrease of 8.50 μmol/L at follow-up (< 0.05). Among the four subgroups, 30 patients with mild renal impaired [eGFR ≥ 60 mL/(min·1.73 m) and <90 mL/(min·1.73 m)] showed an increase of 10.68 mL/(min·1.73 m) in eGFR during follow-up (< 0.01), while the eGFR of the remaining 48 patients with other renal function stages showed no significant change before and after stenting. Moreover, 24 patients experienced cardiovascular or/and renal adverse events.

Conclusions: Renal artery stenting might significantly reduce BP and improve renal function in ARAS patients, particularly those with mild renal impairment, which still requires prospective multicenter studies to confirm.