Surgery Not Always Best for Narrowed Kidney Arteries

Nov. 12 -- WEDNESDAY, Nov. 11 (HealthDay News) -- People suffering from blocked renal arteries fare just as well when treated with medication as they do by having the narrowed artery opened and a stent implanted, British researchers report.

"In asymptomatic people with chronic kidney disease -- people with severe hypertension -- there is no benefit from subjecting them to a risky procedure of revascularization," or restoring the blood flow via artery-opening surgery, said Dr. Philip A. Kalra, a consultant nephrologist at Salford Royal Hospital Trust and the University of Manchester in England and a co-author of the study, published Nov. 12 in the New England Journal of Medicine.

Taking a combination of blood-pressure-lowering drugs, cholesterol-lowering drugs such as statins, and aspirin or another anti-clotting drug can control the condition without the risks associated with revascularization surgery, the researchers said.

For the study, the researchers randomly assigned 806 people with atherosclerotic renovascular disease to have revascularization surgery plus medical treatment or medical treatment alone.

In the next five years, the study found no difference between the groups in blood pressure control or kidney function. The groups had a similar number of kidney and heart problems, and the death rates were also found to be similar.

"There was no difference in renal function in the two arms of the study," Kalra said.

In both groups, blood pressure fell by 7 mmHg, on average, after one year and about 12 mmHg after five years, he noted. About 50 percent of the people in each group had a major cardiovascular event, Kalra said, and 40 percent of those in each group died.

However, 23 people who had revascularization surgery experienced serious side effects. This included two people who died and three who had toes or legs amputated, the study noted.

The most common cause of atherosclerotic renovascular disease is the build-up of plaque on the inside of the arteries that supply blood to the kidneys, causing them to narrow and stiffen, or harden. This can lead to high blood pressure and, eventually, severe kidney damage.