Optimized Blood Pressure Control and Medication Burden Reduction in Bilateral Renal Artery Stenosis Patients Without Pickering Syndrome: A Retrospective Study

Bilateral renal artery stenosis is a major cause of secondary hypertension, yet the benefits of percutaneous transluminal renal angioplasty and stenting in patients without Pickering syndrome remain uncertain. This retrospective study evaluated its effects on blood pressure control, medication burden, and renal function stability in 69 patients treated between 2010 and 2021. Patients with heart failure or pulmonary edema were excluded. Over a mean follow-up of 67.25 months, systolic and diastolic blood pressure significantly decreased, from 152.97 ± 16.97 to 135.48 ± 15.09 mmHg (p < 0.01) and from 84.33 ± 10.69 to 77.83 ± 11.94 mmHg (p < 0.01), respectively. The number of antihypertensive medications was also reduced, from 2.41 ± 1.28 to 1.68 ± 0.93 (p < 0.01). Renal function remained stable overall, with no significant change in serum creatinine (p = 0.094). However, patients with preoperative proteinuria exhibited greater deterioration in renal function during follow-up (p = 0.039), suggesting it may predict post-procedural outcomes. These findings indicate that percutaneous transluminal renal angioplasty and stenting provide sustained benefits in blood pressure control and medication reduction for bilateral renal artery stenosis patients without Pickering syndrome, though those with proteinuria may be at higher risk of renal function decline. Further studies are needed to refine treatment strategies based on individual risk factors.