Dr. Joseph I. Shapiro, dean of the Joan C. Edwards School of Medicine, and a team of researchers around the world had their findings published recently in the New England Journal of Medicine, the premier journal for publishing clinical studies.
The multi-center study included 947 patients with renal-artery stenosis and either high blood pressure or chronic kidney disease, who were then randomized to receive either medical therapy and stenting or medical therapy alone. The study outcomes indicated there was no significant benefit to the population that received the stenting procedure.
Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL), was the largest study examining renal-artery stenting which became popular in the 1990s after some small studies suggested there were benefits to the procedure. Statistics show about 100 million Americans have hypertension and between 1 and 5 percent will develop atherosclerotic renal-artery stenosis.
“Hardening of the arteries to the kidneys is a significant public health issue,” Shapiro, who is a longtime kidney disease researcher, said. “This study was designed to determine whether stenting, with its substantial cost and potential risk, is a viable treatment option for patients with atherosclerotic renal-artery stenosis. Our research indicated that it is not the best option for most patients, ergo, contemporary medical treatment should be our go-to treatment.”
Approximately 40,000 patients per year undergo a renal-artery stent in the United States. If the results of the CORAL trial are embraced, there will be substantial financial savings in the care of these patients.
Shapiro served as the enrollment chairman for the study.