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A Prospective Danish National Registry of PTRA in Patients With Renovascular Hypertension

Recruiting
Conditions
Hypertension, Renovascular
Cardiovascular Diseases
Renal Artery Obstruction
Kidney Diseases
Registration Number
NCT02770066
Lead Sponsor
University of Aarhus
Brief Summary

A prospective Danish national registry of percutaneous transluminal renal angioplasty (PTRA) in high-risk patients with renal artery stenosis selected on the basis of common national criteria, and with a common follow-up protocol for all three Danish centres offering PTRA

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria

All of the following:

  1. At least one of the above eligibility criteria
  2. Duplex doppler ultrasonography or renography investigations consistent with hemodynamically significant renal artery stenosis
  3. CT angiography or renal arteriography with angiographic renal artery stenosis of ≥ 70 % reduction of the luminal diameter in at least one projection
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Exclusion Criteria
  1. If angiography/arteriography, ultrasonography or renography is consistent with bilateral significant renal artery stenosis and only one side is treated with PTRA
  2. PTRA of a renal artery supplying a kidney which pre-PTRA handles ≤ 10% of the total kidney function (with no blockage of the renin-angiotensin system) and has a kidney size < 7 cm (length)
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Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Changes in 24-hour ambulatory systolic and diastolic blood pressures from baseline to 24 months after PTRA in patients with 24-hour ambulatory average systolic blood pressure ≥ 150 mmHg at baselineMeasured 24 months post-PTRA

Changes in 24-hour ambulatory systolic and diastolic blood pressures (calculated from hourly means) from baseline to 24 months after percutaneous transluminal renal angioplasty in patients with 24-hour ambulatory average systolic blood pressure ≥ 150 mmHg at baseline and with significant artery stenosis either

1. Unilaterally (one or two kidneys)

2. Bilaterally with treatment of both kidneys

All 24-hour ambulatory blood pressure measurements are performed after nurse-administered medication. Likewise, it will below be inferred that renal artery stenosis is defined as in the primary endpoint.

Secondary Outcome Measures
NameTimeMethod
Changes in 24-hour ambulatory systolic and diastolic blood pressures from baseline to 24 months after PTRA in patients with 24-hour ambulatory average systolic blood pressure ≥ 130 mmHg at baselineMeasured 24 months post-PTRA

Changes in 24-hour ambulatory systolic and diastolic blood pressures (calculated from hourly means) from baseline to 24 months after percutaneous transluminal renal angioplasty in patients with 24-hour ambulatory average systolic blood pressure ≥ 130 mmHg at baseline and with significant artery stenosis

Change in antihypertensive treatment (defined daily doses)Measured at 3, 12, 24, 36, 48 and 60 months
Change in kidney functionMeasured at 3, 12, 24, 36, 48 and 60 months

Change in estimated glomerular filtration rate (eGFR) and change in percentage side distribution measured by renography at baseline and 24 months after PTRA

Changes in 24-hour ambulatory systolic and diastolic blood pressures (statistically adjusted for treatment changes) from baseline to 24 months after PTRA in patients with 24-hour ambulatory average systolic blood pressure ≥ 150 mmHg at baselineMeasured 24 months post-PTRA

Changes in 24-hour ambulatory systolic and diastolic blood pressures (calculated from hourly means) (statistically adjusted for treatment changes) from baseline to 24 months after percutaneous transluminal renal angioplasty in patients with 24-hour ambulatory average systolic blood pressure ≥ 150 mmHg at baseline and with significant artery stenosis

Changes in 24-hour ambulatory systolic and diastolic blood pressures (statistically adjusted for treatment changes) from baseline to 24 months after PTRA in patients with 24-hour ambulatory average systolic blood pressure ≥ 130 mmHg at baselineMeasured 24 months post-PTRA

Changes in 24-hour ambulatory systolic and diastolic blood pressures (calculated from hourly means) (statistically adjusted for treatment changes) from baseline to 24 months after percutaneous transluminal renal angioplasty in patients with 24-hour ambulatory average systolic blood pressure ≥ 130 mmHg at baseline and with significant artery stenosis

Changes in 24-hour ambulatory systolic and diastolic blood pressures (unadjusted and statistically adjusted for treatment changes)Measured at 3, 12, 36, 48 and 60 months

Changes in 24-hour ambulatory systolic and diastolic blood pressures (unadjusted and statistically adjusted for treatment changes) from baseline to 3, 12, 36, 48 and 60 months after PTRA in patients with 24-hour ambulatory average systolic blood pressure ≥ 150 mmHg and in patients with 24-hour ambulatory average systolic blood pressure ≥ 130 mmHg

Clinical composite end pointMeasured at 3, 12, 24, 36, 48 and 60 months

Clinical composite end point

1. death from cardiovascular causes

2. death from renal causes

3. stroke

4. myocardial infarction

5. hospitalization for congestive heart failure

6. progressive renal insufficiency (a reduction from baseline of 30% or more in eGFR)

7. permanent renal-replacement therapy

Only the first event per participant is included in the composite

Safety composite end point (< 30 days after PTRA)Measured at 3, 12, 24, 36, 48 and 60 months

Safety composite end point (\< 30 days after PTRA)

1. all cause mortality

2. rupture, dissection, perforation or occlusion of renal artery

3. critical bleeding (need of blood transfusion)

4. embolization

5. significant loss of kidney function (reduction from baseline of 30% or more in eGFR)

6. ipsilateral nephrectomy

7. pseudoaneurysm formation

8. stent thrombosis

Only the first event per participant is included in the composite

Trial Locations

Locations (5)

Holbaek Hospital

🇩🇰

Holbaek, Denmark

Aalborg University Hospital

🇩🇰

Aalborg, Denmark

Odense University Hospital

🇩🇰

Odense C, Denmark

Aarhus University Hospital

🇩🇰

Aarhus N, Denmark

Glostrup University Hospital/ Rigshospitalet

🇩🇰

Glostrup, Denmark

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