Prognostic indicator by urinary microglobulin after renal stenting

Objective To evaluate the effect of revascularization of the renal artery on urinary microglobulin in patients with coronary artery disease and significant renal artery stenosis (RAS). Methods Forty-four patients with coronary artery disease and severe RAS (luminal narrowing >70%) underwent percutaneous transluminal renal artery angioplasty (PTRA) and stenting, as well as percutane-ous coronary intervention. The urine -microglobulin ( o^-MG) and P2-Cmicroglobulin (P,-MG) at baseline and at 3 months after the procedures were measured. Procedural success rate, procedural complications, serum creatinine concentration at baseline and at 3-months were also recorded. Results At 3-months after the renal revascularization therapy, there was no significant change of urine o^-MG compared with that of the baseline, however, the urine (3,-MG decreased significantly 3-months after the treatment (237+ 187^g/L vs 377±173 |J.g/L, P<0.01). Multivariate analysis revealed that persistent elevation of urine was an independent predictor of severe events (including re-admission and renal failure) after renal revascularization therapy in patients with severe RAS (OR=3.01, 95% Cl 1.01-8.95, P=0.036). Conclusions In patients with coronary artery disease and severe RAS, revascularization with PTRA and stenting may improve renal tubular function, but a continuous high level of urinary microglobulins after intervention is associated with more frequent re-hospitalization and renal failure.