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3 . 2026

Stenting of renal arteries in arterial hypertension and initial stages of chronic kidney disease (C1 and C2)

Abstract

There is currently no answer to the question as to from the point of view of normalization of renal filtrating function it is expedient to perform stenting of renal arteries (RA) at initial stages of chronic kidney disease (CKD) at an estimated glomerular filtration rate (GFR) >60- 80 ml/min/1.73 m2 even in significant stenoses (>70%).

Objective. To assess clinical effects after RA stenting in patients with arterial hypertension (AH) and chronic kidney disease 1C and 2C (KDIGO 2013).

Patients and methods. Our retrospective study included a total of 40 patients with hemodynamically significant stenoses of RA, AH and CKD 1C and 2C. RA patency was restored by stenting. Treatment results were assessed at discharge, 1 postoperative month, then at 1, 3 and 5 years. The endpoints – changes in the average blood pressure (BP) and alteration of renal function.

Results. The average systolic BP prior to operation amounted to 196±7.6 mm Hg, at 1 year postoperatively – 142±11.7 mm Hg, at 3 years – 158±17.2 mm Hg. The difference turned out to be statistically significant (p<0.001). The dispersion analysis showed regularities in renal function changes after restoration of RA patency. A statistically significant increase of the GFR was noted during the first postoperative months (prior to operation vs 6 months: p=0.001 (the most significant effect), to be then followed by a gradual decrease, with the preoperative GFR not significantly differing from that at 36 months (p>0.05), meaning that renal function remained stable, but after 3 months returned to the baseline, preoperative level. During the period after 36 months the median GFR (73.0 ml/min/1.73 m2) dropped below the initial preoperative level (78.5 ml/min/1.73 m2) (p<0.05). The multivariable Cox regression analysis demonstrated that a statistically significant risk factor for deterioration of renal function was only the preoperative presence of proteinuria – HR = 4.22 (p=0.009).

Conclusion. In a patient with vasorenal AH and CKD 1C and 2C, a clinical effect in the form of improvement and stabilization of renal function may surely be expected in the period up to 3 years after removal of RA stenosis, with the most unfavorable prognosis as to progressing deterioration of renal function being characteristic of patients with baseline proteinuria.

Keywords:renal arteries; vasorenal arterial hypertension; chronic kidney disease; renal function; renal artery stenting

Author’s contribution. Study conception and design – Frolova E.V., Vachev A.N.; data collection and handling – Kamenev E.V., Frolova E.V.; statistical processing – Sevriukova V.N., draft manuscript preparation – Frolova E.V., Kamenev E.V.; manuscript revision – Vachev A.N.

For citation: Frolova E.V., Kamenev E.V., Sevriukova V.N., Vachev A.N. Stenting of renal arteries in arterial hypertension and initial stages of chronic kidney disease (C1 and C2). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2026; 32 (3): 71–7. DOI: https://doi.org/10.33029/1027-6661-2026-32-3-71-77

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CHIEF EDITOR
CHIEF EDITOR
Yuri V. Belov
Academician of the Russian Academy of Sciences Doctor of Medical Sciences, Professor, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.

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