OBJECTIVETo assess plasma renin activity (PRA) of renal veins in patients with unilateral renal artery atherosclerotic stenosis and its relationship with blood pressure changes after renal artery stenting.

METHODSFifty patients with significantly unilateral renal artery stenosis (lumen loss > or = 70%) and coronary artery stenosis were included. Bilateral renal vein and peripheral PRA and angiotensin II were determined and their relations with blood pressure changes after stenting were analyzed.

RESULTSAll patients were revascularized successfully for both coronary and renal artery stenosis. PRA in the ischemic kidney was significantly higher than that in the contralateral kidney (1.44 +/- 1.73 ng.ml(-1).h(-1) vs 1.27 +/- 1.57 ng.ml(-1).h(-1), P = 0.04). Ischemic and contralateral renal vein renin ratio (RVRR) was > or = 1.5 in 14 patients (28%) (renal vascular hypertension, RVH group). During follow-up (12 +/- 9 months), blood pressure returned to normal in 9 patients after revascularization, 7 were of RVH group (50%) and 2 were in control group (6%) (P < 0.001). Multivariate logistic analysis indicated RVRR > or = 1.5 was significantly related to the decrease of hypertension after renal artery stenting (OR = 3.15, 95% CI = 1.49 approximately 5.97, P = 0.02).

CONCLUSIONSPRA was significantly increased in the ischemic kidney in about one-third of patients with unilateral renal artery stenosis. Hypertension could be controlled easily to normal value after renal artery stenting in half of the patients with RVRR > or = 1.5. Measurement of renal vein renin activity in patients with renal artery stenosis is very useful in evaluating the effects of renal artery stenting on hypertension.