In her doctoral dissertation, Liesbeth Bax concludes that medication should be used instead of a stent to treat patients with impaired renal function and atherosclerotic renal artery stenosis (ARAS).
She carried out the first randomized study into the costs and benefits of stent placement combined with medication versus medication alone. For both groups (a total of 140 patients), the medication consisted of blood pressure and cholesterol-lowering medicines and aspirin. After two years, she found no significant difference between the two groups at the primary end point, a 20 percent decrease in kidney function. However, serious complications did occur in the stent group, with a mortality rate of 3 percent. These findings support conservative medicinal therapy, and the outcomes are of great importance for clinical practice.
Stent placement is still carried out on a large scale. If placing a stent does not benefit patients, they should not be exposed unnecessarily to possible complications. This means that patients with renal impairment and ARAS should be treated primarily with medication. To do this, the focus should be on properly treating blood pressure and lowering cholesterol.
Liesbeth Bax will receive her PhD from UMC Utrecht on August 29. The title of her dissertation is “Renal function and atherosclerotic renovascular disease.”