Therapy

Consider renal angioplasty ^a or medication. 

Why?

• Balloon angioplasty is not clearly more effective than  drug therapy at lowering systolic or diastolic blood pressure at 3 months. ^a
• Angioplasty leads to small improvement in creatinine clearance (around 11 ml/min) compared with drug therapy, and one fewer dose of medication per day. ^a
• Fewer patients who receive angioplasty undergo an invasive intervention within the next 3 months. ^a

ACE inhibitors reduce mortality in a scleroderma renal crisis

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
atherosclerotic renal artery stenosis and drug-resistant hypertension a	renal angioplasty	drug therapy	further intervention at 3 months	44%	88% (62% to 96%)	3 (2 to 4)