A San Antonio physician has completed a study that shows renal artery stents should no longer be recommended for patients with chronic kidney disease and high blood pressure. The new recommendations are predicted to save millions of dollars in future medical costs.
Dr. William Henrich, president of San Antonio’s UT Health Science Center, found that millions of renal stents placed in older patients with kidney disease and high blood pressure may not have done any good -- and created billions of costs in Medicare dollars.
Henrich said the procedure is risky and expensive. It involves sliding a catheter up the aorta to the renal artery opening, doing an angioplasty and inserting a titanium-based stent in the renal artery. It became popular in the late 90s.
"Between 1996 and 2000, the number of procedures increased fourfold, that Medicare was funding," Henrich said.
The study, Cardiovascular Outcomes in Renal Atherosclerotic Lesions, was presented at a medical conference in Dallas on Tuesday. Investigators found no difference between the groups in the occurrence of cardiovascular and renal events such as heart attack, stroke, hospitalization for congestive heart failure and progressive renal insufficiency.
Henrich said going forward, instead of receiving renal stent recommendations, patients will be sent for medical therapy.
"In this study, we used two different kinds of anti-hypertensive medicines, a diuretic and a drug that blocks a hormonal system linked to hypertension," Henrich said. "We also used lipid-lowering agents. Patients took a baby aspirin to keep all blood vessels on the arterial side of the circulation open and patent. And they were followed up with regard to weight and diet and so forth, and they did very well."
Henrich wrote the grant for the study in 1998 when he worked at Medical College in Ohio. Fifteen years and two professional moves later, Henrich completed the study that he expects will change the way renal hardening of the arteries is treated for millions of patients.