d-arg-dmt-lys-phe-nh2 and Hypoxia

Atherosclerotic renal artery stenosis reduces renal blood flow (RBF) and amplifies stenotic kidney hypoxia. Revascularization with percutaneous transluminal renal angioplasty (PTRA) and stenting often fails to recover renal function, possibly because of ischemia/reperfusion injury developing after PTRA. Elamipretide is a mitochondrial-targeted peptide that binds to cardiolipin and stabilizes mitochondrial function. We tested the hypothesis that elamipretide plus PTRA would improve renal function, oxygenation, and RBF in patients with atherosclerotic renal artery stenosis undergoing PTRA.. Adjunctive elamipretide during PTRA was associated with attenuated postprocedural hypoxia, increased RBF, and improved kidney function in this pilot trial. These data support a role for targeted mitochondrial protection to minimize procedure-associated ischemic injury and to improve outcomes of revascularization for human atherosclerotic renal artery stenosis.. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01755858.

Topics: Aged; Angioplasty, Balloon; Antioxidants; Atherosclerosis; Computed Tomography Angiography; Double-Blind Method; Female; Glomerular Filtration Rate; Humans; Hypoxia; Infusions, Intravenous; Kidney; Magnetic Resonance Imaging; Male; Middle Aged; Mitochondria; Multidetector Computed Tomography; Oligopeptides; Oxidative Stress; Perfusion Imaging; Pilot Projects; Recovery of Function; Renal Artery Obstruction; Renal Circulation; Reperfusion Injury; Risk Factors; Stents; Time Factors; Treatment Outcome