For patients with renal artery stenosis, is revascularizarization more effective than medical therapy for improving outcomes?

Bottom line: There is no data to support percutaneous revascularization for patients with resistant hypertension and significant renal artery stenosis.

SummaryClinical outcomes after percutaneous revascularization versus medical management in patients with significant renal artery stenosis: a meta-analysis of randomized controlled trials. Am Heart J 2011 Mar;161(3):622-30.

Meta-analysis of 6 RCTs (randomized controlled trials) that assessed percutaneous revascularization with medical therapy as needed compared to medical therapy alone in 1,208 patients (renal artery stenosis ≥ 50%). Did not assess quality of RCTs. RESULTS: Found no significant differences between the two groups in all-cause mortality, heart failure, stroke, worsening renal function (≥ 20% decrease in estimated creatinine clearance or ≥ 50% increase in serum creatinine), systolic and diastolic blood pressure, or serum creatinine. Fig. 3 (p. 627) displays forest plots pooling data on mortality, CHF and worsening renal failure for the six trials.

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About Amy

Clinical Informationist at EUH Branch Library
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