Comparison of blood pressure and radionuclide renal dynamic imaging before and after stent treatment for unilateral renal artery stenosis

HAO Fang; ZHANG Xin; ZHANG Xiaoning; CHEN Shaobo

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Medical Journal of the Chinese People Armed Police Forces ›› 2023, Vol. 34 ›› Issue (11) : 949-953.

Comparison of blood pressure and radionuclide renal dynamic imaging before and after stent treatment for unilateral renal artery stenosis

HAO Fang, ZHANG Xin, ZHANG Xiaoning, CHEN Shaobo

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Abstract

Objective To investigate the changes of blood pressure and GFR of radionuclide renal dynamic imaging after unilateral renal artery stenosis stent treatment. Methods From January 2018 to January 2023, 40 patients who underwent percutaneous unilateral renal artery stent implantation were selected for this study. GFR was measured using radionuclide renal dynamic imaging before and 6 months after stent implantation. All patients were tested for SCR and Cys-C levels before and 6 months after stent implantation. GFR was calculated synchronously using different GFR calculation formulas and compared with radionuclide renal dynamic imaging. After stent implantation, all patients completed a 6-month follow-up to observe changes in blood pressure. Results The systolic blood pressure and diastolic blood pressure decreased significantly in 24 h ambulatory blood pressure test in 40 patients 6 months after renal artery stenting treatment, and the types of antihypertensive drugs decreased. Before stent treatment, the GFR of radionuclide renal dynamic imaging was (61.38±5.72) ml/min, and 6 months after stent treatment, the GFR of radionuclide renal dynamic imaging was (70.07±6.53) ml/min, which was significantly higher than that before treatment, and the difference was statistically significant (P<0.01). Compared with the GFR measured by radionuclide renal dynamic imaging, there was difference (P<0.01) in the GFR calculated by the MDRD formula, CKD-EPISCr formula, and CKD-EPICysC formula. The GFR calculated by the CKD-EPICysC formula had the smallest difference compared to the GFR measured by radionuclide renal dynamic imaging. Conclusions The accuracy of GFR measured by radionuclide renal dynamic imaging is high,and the use of radionuclide renal dynamic imaging to guide the stenting treatment of severe unilateral renal artery stenosis can significantly improve the clinical prognosis.

Key words

renal artery stenosis / interventional therapy / stent / radionuclide renal dynamic imaging / glomerular filtration rate

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HAO Fang, ZHANG Xin, ZHANG Xiaoning, CHEN Shaobo. Comparison of blood pressure and radionuclide renal dynamic imaging before and after stent treatment for unilateral renal artery stenosis[J]. Medical Journal of the Chinese People Armed Police Forces. 2023, 34(11): 949-953

References

[1] Zhao J, Cheng Q, Zhang X, et al. Efficacy of percutaneous transluminal renal angioplasty with stent in elderly male patients with atherosclerotic renal artery stenosis[J]. Clin Interv Aging,2012, 7(3): 417-422.
[2] Kwon S H, Lerman L O. Atherosclerotic renal artery stenosis current status[J]. Adv Chronic Kidney Dis, 2015, 22(3): 224-231.
[3] 中国医疗保健国际交流促进会血管疾病高血压分会专家共识起草组.肾动脉狭窄的诊断和处理中国专家共识[J].中国循环杂志,2017, 32 (9):835-844.
[4] 牛国晨,闫子光,张碧辉,等. 肾动脉狭窄血管腔内成形术治疗高血压:现状与展望[J].中国介入心脏病学杂志,2022,30(7):513-517.
[5] 董永明,任补元.肾动脉狭窄治疗的研究进展[J]. 内蒙古医学杂志,2023,5(1):73-74.
[6] Ronden R A, Houben A J, Kessels A G, et al. Predictors of clinical outcome after stent placement in atherosclerotic renal artery stenosis: a systematic review and meta-analysis of prospective studies[J]. J Hypertens,2010,28(6):2370-377.
[7] Courand P Y, Dinic M, Lorthioir A, et al. Resistant hypertension and atherosclerotic renal artery stenosis: effects of angioplasty on ambulatory blood pressure. A retrospective uncontrolled single-center study[J]. Hypertension,2019,74(3):1516-1523.
[8] Caielli P, Frigo A C, Pengo M F,et al. Treatment of atherosclerotic renovascular hypertension: review of observational studies and a meta-analysis of randomized clinical trials[J]. Nephrol Dial Transplant,2015,30(9):541-553.
[9] 周海鹏,张志强,王亚松,等. 经皮肾动脉支架置入术治疗动脉粥样硬化性肾动脉狭窄长期临床效果观察[J]. 临床军医杂志,2022,50(11 ):1116-120.
[10] Vivek B,Stephen C, Joshua A B,et al. Revascularization for renovascular disease:a scientific statement from the american heart association[J]. Hypertension, 2022,79(6):e1-e16.
[11] 齐一侠,陈兵,俞恒锡,等.肾动脉支架成形术对血压、肾功能影响及临床应用价值[J].武警医学,2014,25(9):908-915.
[12] 白子良.肾动脉支架置入后对肾动脉狭窄患者肾功能的影响[J]. 山西医药杂志,2022,51(14):1610-1611.
[13] 王悦喜,范小娇,阿荣,等. 肾动脉支架置入术治疗老年高血压合并肾动脉狭窄患者的疗效观察[J]. 中华老年心脑血管病杂志,2022,24(5):495-498.
[14] Herrmann S M, Saad A, Eirin A, et al. Differences in GFR and tissue oxygenation,and interactions between stenotic and contralateral kidneys in unilateral atherosclerotic renovascular disease[J]. Clin J Am Soc Nephrol,2016,11(8):458-469.
[15] 张新鹏,吴丽娜. 4种估算肾小球滤过率计算公式对患者肾功能的评估结果比较[J]. 国际检验医学杂志,2020,41(18):2214-2218.
[16] 林春生,姚月娴,蔡文钦,等. 不同肾小球滤过率计算公式在高血压患者肾功能分期中的价值[J]. 中国当代医药,2022 ,29 (33):19-23.
[17] 付帅,晓宁. 肾小球滤过率计算公式研究进展:从Cockcroft-Gault公式到FAS公式[J]. 临床肾脏病病杂志,2020,20(1):73-77.
[18] 付帅,徐丝,杨敏,等. 血清胱抑素C公式和肌酐公式对评估中国人肾小球滤过率精准度的比较[J]. 临床肾脏病杂志,2020,20(5):351-384.
[19] 张学敏,马丽,陈正福. 核素肾动态显像测定GFR在化疗患者早期肾功能损害评估中应用[J]. 医学影像学杂志,2016,26(6):1055-1057.
[20] Itoh K. Comparison of methods for determination of glomerular filtration rate: Te-99m-DTPA renography, predicted ereatinine clearance method and plasma sample method[J]. Ann Nucl Med, 2003, 17(11):561-565.
[21] 潘德璋,龙志军,聂善化,等. 肾小球滤过率、肌钙蛋白T水平与肾性贫血的相关性分析[J].武警医学,2022,33(5):404-406.
[22] 李华君,董艳芳,孔五宝,等. 核素肾动态显像联合实验室指标预测糖尿病肾病患者预后的价值[J]. 解放军医药杂志,2022,34(8):41-45.
[23] 李飞,邓庆梅,黄山,等. 核素肾动态显像评估12种肾小球滤过率计算公式在肾脏疾病中应用[J]. 生物医学工程与临床,2021,25(2):170-178.
[24] 段磊,顾俊鹏,任伟新,等. ^99mTc-DAPA 肾动态显像对动脉粥样硬化性肾动脉狭窄支架置入术疗效的预测价值[J]. 中华介入放射学电子杂志,2020,8(2):175-179.