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The following is a summary of “Hypertensive load predicts recovery of renal function for patients undergoing revascularisation for renal artery stenosis,” published in the January 2025 issue of Nephrology by Edgar et al.
Renal ischemia from renal artery stenosis causes a hypertensive response and cortical dysfunction. The reversibility of renal impairment is unpredictable, making revascularization controversial.
Researchers conducted a retrospective study to evaluate if the hypertensive response to renal ischemia predicts viable renal parenchyma and recovery of renal function.
They performed a retrospective analysis of all patients who had renal revascularization for renal impairment in the West of Scotland (population 2.4 million) between 2008 and 2024. Clinical records were used to determine pre-intervention blood pressure, antihypertensive medication load, renal function, and post-intervention outcomes. The Hypertensive Index (HTi), a combined measure of systolic blood pressure and antihypertensive drug load, was used to assess the pre-intervention hypertensive response.
The results showed that 75 patients had intervention for renal impairment over 15 years (68 endovascular, 7 open). Mean pre-intervention serum creatinine of 323 µmol/L was reduced to 191 µmol/L at discharge and 182 µmol/L at 6-month follow-up. Refractory hypertension (HTi > 120) was linked to improved renal function (P = 0.003) and reduced dialysis risk (P = 0.001). Renal impairment with no hypertensive response predicted future dialysis need.
Investigators found that the hypertensive index predicted the impact of renal revascularization on improving renal function in selected patients. The absence of this index indicated chronic non-reversible renal dysfunction.
Source: nature.com/articles/s41598-025-86663-y
