2022 Fiscal Year Final Research Report
Elucidation of appropriate patients for percutaneous transluminal renal angioplasty treatment
| Project/Area Number |
17K09743
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Kidney internal medicine
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| Research Institution | Kansai Medical University (2022)
Dokkyo Medical University (2019-2021)
National Cardiovascular Center Research Institute (2017-2018) |
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Principal Investigator |
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| Project Period (FY) |
2017-04-01 – 2023-03-31
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| Keywords | 腎血管性高血圧 / 腎動脈狭窄 / 経皮的腎動脈形成術 / 線維筋性異形成 / 高血圧 |
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| Outline of Final Research Achievements |
Renovascular hypertension is one of the most common causes of secondary hypertension. We investigated the pathogenetic change after percutaneous transluminal renal angioplasty (PTA), and identify factors that may predict which patients are most likely to benefit from PTA. Our investigations found that (1) PTA treatment produced a greater decrease of morning home systolic blood pressure (BP) in fibromuscular dysplasia (FMD), and improved BP variability irrespective of BP response. Measurement of home BP seems to be important for treatment success, especially in atherosclerotic renal artery stenosis. (2) PTA can be expected to have a regressive effect on cardiac hypertrophy, (3) preoperative renal function is associated with outcome, and could be a predictor of postoperative renal function, (4) intrarenal perfusion might be a key modulator of the circadian patterns of BP, autonomic nerve activity, and natriuresis, and (5) the characterization of distinct profiles of FMD patients.
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| Free Research Field |
高血圧学
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| Academic Significance and Societal Importance of the Research Achievements |
腎血管性高血圧は腎動脈の狭窄や閉塞を原因とする高血圧で、降圧薬が効きにくい治療抵抗性高血圧の原因疾患の一つである。経皮的腎動脈形成術(PTA)はその治療法の一つであり、血圧コントロールの改善をもたらすことも多く、効果的と考えられる。しかしながら、そのエビデンスは十分ではなく、血行改善に伴う病態の変化にも不明な部分が多い。とくに、同治療法が望まれる具体的な患者像に関するエビデンスが少ないことから、本研究では、PTAに伴う病態の変化や、治療効果を予測するための有用な指標を検討した。得られた知見は、腎臓内の虚血がもたらす病態の知見を深めただけでなく、治療選択のための重要な成果となると考えられる。
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