The Impact of Renal Artery Stenting on Renal Cortical Thickness and Volume

Purpose: There are limited data on the effect of renal artery stent placement on kidney atrophy. The purpose of this study was to assess the impact renal artery stent placement on renal cortical diameter and volume in patients with chronic kidney disease (CKD).

Materials and Methods: Retrospective chart review of patients who had undergone unilateral or bilateral renal artery stenting for atherosclerotic renal artery stenosis between 2015 and 2020 was completed. Clinical data including demographics, estimated glomerular filtration rate (eGFR), comorbidities, and medications were collected. Renal cortical thickness measurements were determined from renal ultrasound (US) imaging before stenting as well as approximately 12 months after stenting. Subgroup analysis was performed on renal cortical volume changes at contrast-enhanced computed tomography after stenting using a deep-learning automated segmentation tool.

Results: A total of 86 individual renal arteries were stented in 65 patients. Mean eGFR was 44.6 ± 18.5 mL/min/1.73 m², which correlates with stage 3 CKD. Mean US follow-up time was 372.7 ± 179.2 days. The mean cortical thickness measured by US before intervention was 7.6 ± 2.8 mm. After stent placement, the mean cortical thickness increased to 8.0 ± 3.3 mm, which was not statistically significant (P = 0.38). The mean time between pre- and postintervention CTs was 505.3 ± 334.4 days. Cortical volume also did not significantly change after revascularization (preintervention, 104.5 ± 54.8 cm³; postintervention,102.8 ± 46.0 cm³; P = 0.65).

Conclusions: No significant change in renal cortical diameter or volume occurred after renal artery stent placement over a mean follow-up time greater than 1 year. These results suggest renal artery revascularization may stabilize renal atrophy in patients with CKD.