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Despite findings from prior studies that failed to show a benefit of renal-artery stenting in patients with atherosclerotic stenoses and hypertension (NEJM JW Gen Med Nov 12 2009), enthusiasm for the procedure has remained unabated in many quarters. The refrain from some doctors I know was that they were waiting for the results of the CORAL trial before considering practice change. Those results have now arrived.
The CORAL investigators randomized 947 patients with resistant hypertension or stage ≥3 chronic kidney disease and atherosclerotic renal-artery stenosis (mean stenosis, 73%) to medical therapy either with or without stenting. At a median follow-up of 43 months, the primary endpoint (a composite of death from cardiovascular or renal …