Renal Atherosclerotic Revascularization Evaluation: RAVE Study

Sunnybrook Health Sciences Centre240 enrolled

Overview

The RAVE study will compare renal revascularization to medical management for people with atherosclerotic renal vascular disease (ARVD) and the indication for revascularization.

It is uncertain whether patients with renal vascular disease will have renal or mortality benefits from re-establishing renal blood flow with renal revascularization procedures. Patients will be assessed for the standard nephrology research outcomes of progression to doubling of creatinine, need for dialysis, and death, as well as other cardiovascular outcomes. The investigators will also establish whether the use of a new inexpensive, simple and available ultrasound test, the renal resistance index (RRI), can identify patients with renal vascular disease who will not benefit from renal revascularization procedures.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

240

Conditions

Hypertension, Renovascular

Interventions

Angiographic renal revascularizationPROCEDURE

Eligibility

Sex: ALLMin age: 55 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Systolic blood pressure \> 140 mmHg and/or diastolic blood pressure \> 90 mmHg despite at least 3 antihypertensive medications * Systolic blood pressure \>140 mmHg and/or diastolic blood pressure \> 90 mmHg on two antihypertensives with: a rise in creatinine \> 20% after initiation of an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB); the sudden onset of hypertension occurring after age 55; hypokalemia or the presence of an abdominal bruit; a history of flash pulmonary edema; or any three of: peripheral vascular disease, coronary artery disease, cerebrovascular disease, smoking, hyperlipidemia, diabetes or male gender. Exclusion Criteria: * Serum creatinine \> 220 umol/L or estimated glomerular filtration rate (GFR) by Cockroft-Gault equation \< 20 ml/min * Patients who are unwilling or unable to give informed consent * Known contraindication to renal revascularization such as anaphylactic allergy to contrast dye * An abdominal aortic aneurysm requiring surgery * A single functioning kidney; a total occlusion of the renal artery or renal artery stenosis due to fibromuscular dysplasia. * Previous revascularization

Locations (1)

Sunnybrook & Women's College Health Sciences Centre

Toronto, Ontario, Canada

Outcomes

Primary Outcomes

Dialysis

Death

Doubling of creatinine

Data from ClinicalTrials.gov

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