Percutaneous angioplasty and stenting of the renal artery in a dialysis patient with recovery of residual renal function: a case report
DOI:
https://doi.org/10.48750/acv.652Keywords:
Renovascular disease, Renal artery stenosis, Haemodialysis, Renal artery stenting, EndovascularAbstract
INTRODUCTION: Renal artery stenosis is the leading cause of secondary hypertension. The prevalence of this condition varies, being higher in patients with refractory hypertension and in those with atherosclerotic involvement of other territories. Revascularisation with stenting is the main therapeutic option; however, the benefits regarding the recovery of renal function in patients already on dialysis remain controversial.
CASE-REPORT: This is a case of a 72-year-old female patient with a history of refractory hypertension and chronic kidney disease, with a single kidney. After multiple hospitalisations due to hypertensive crises and acute pulmonary oedema, she was admitted for worsening renal function requiring dialysis. Diagnostic exams revealed partial aortic thrombosis with critical stenosis of the right renal artery. She underwent angioplasty and stenting of the renal artery, resulting in blood pressure control and discontinuation of dialysis. Two years post-procedure, the patient maintains controlled blood pressure with two medications and stable renal function.
CONCLUSIONS: Renal revascularisation can be beneficial in patients with renal artery stenosis on dialysis if performed within three months of initiating renal replacement therapy. The decision to revascularise a patient already on dialysis due to renal ischaemia should consider factors such as the duration of dialysis, kidney size, and the presence of residual arterial flow.
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