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Kidney Angioplasty Brings Risk Without Benefit

Fri, 11/13/2009 - 5:47am

Linda A. Johnson, AP

A recent report states that hundreds of thousands of Americans with clogged kidney arteries might want to consider trying medicines before rushing into angioplasty to open them up. The pricey procedure is no more effective and carries surprisingly big risks, a study found.

The National Kidney Foundation estimates more than 250,000 Americans have narrowing of the arteries that supply blood to the kidneys. It's usually caused by a buildup of fatty plaque and can result in high blood pressure or even kidney failure. Each year, about one in six patients with the condition dies.

About 16 percent of patients with newly diagnosed blockages in kidney blood vessels undergo angioplasty or, occasionally, more-invasive artery bypass surgery. Doctors at several British hospitals and universities compared patients with severe kidney artery blockages who were treated just with medicines with a group that got the same drugs and underwent angioplasty, in which a catheter is threaded through an artery to clear out blockages. The angioplasty group fared no better — and some of those patients suffered serious complications, including deaths and amputations.

Dr. Harlan Krumholz, a cardiologist and health outcomes researcher at Yale University feels that doctors believe some treatments have obvious benefits, but recently a series of studies have upended conventional wisdom. That means precious health care dollars are being wasted and patients are enduring unnecessary procedures and risks.

The study was published in Thursday's New England Journal of Medicine. This report “is the first hint” that medication may produce equal results to angioplasty, said Dr. Leslie Spry, a kidney foundation spokesman. He said there's an ongoing U.S. study of the same issue.

The foundation's president, Dr. Bryan Becker, said the patients getting angioplasty may not have fared better because they had blockages in small blood vessels in addition to the blocked large blood vessels feeding the kidneys that were cleared out.

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