Racial-Based Outcomes of Renal Artery Stenting in Atherosclerotic Renal Artery Stenosis: A Propensity-Matched Analysis of the National Inpatient Sample

Renal artery stenosis (RAS) from atherosclerosis is common in the elderly and linked to several risk factors. It can lead to renal artery atrophy and worsening renal function. Percutaneous renal artery stenting is a standard treatment for RAS, but outcomes based on racial demographics remain understudied. The study utilized data from the Nationwide Inpatient Sample spanning 2016-2021 to examine atherosclerotic RAS cases in patients who underwent renal artery stent placement. The primary outcomes assessed included mortality, acute kidney injury, heart failure, stroke, myocardial infarction, and major adverse cardiac and cerebrovascular events (MACCE). A total of 1110 African American patients and 9340 Caucasian patients were admitted for renal artery stenting due to RAS. The data indicated that African Americans exhibited a higher prevalence of baseline risk factors associated with atherosclerosis. Following propensity score matching, it was revealed that African Americans had more significant associations with several adverse outcomes: heart failure (39.19% vs 35.93%), acute kidney injury (46.66% vs 42.51%), kidney transplants (3.76% vs 0.5%), acute stroke (18.63% vs 13.43%), and MACCE (24.65% vs 20.34%). No significant difference in inpatient mortality rates was observed between the 2 groups. Furthermore, female patients experienced more extended hospital stays than male patients. Racial disparities in RAS are concerning. Among patients who underwent renal artery stenting, African Americans had a notably higher incidence of heart failure, MACCE, and acute stroke compared with Caucasians. Addressing these disparities is crucial for improving health outcomes.