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Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function A Randomized Trial Liesbeth Bax, MD, PhD; Arend-Jan J. Woittiez, MD, PhD; Hans J. Kouwenberg, MD; Willem P.T.M. Mali, MD, PhD; Erik Buskens, MD, PhD; Frederik J.A. Beek, MD, PhD; Branko Braam, MD, PhD; Frans T.M. Huysmans, MD, PhD; Leo J. Schultze Kool, MD, PhD; Matthieu J.C.M. Rutten, MD; Cornelius J. Doorenbos, MD, PhD; Johannes C.N.M. Aarts, MD; Ton J. Rabelink, MD, PhD; Pierre-Franc ?ois Plouin, MD; Alain Raynaud, MD; Gert A. van Montfrans, MD, PhD; Jim A. Reekers, MD, PhD; Anton H. van den Meiracker, MD, PhD; Peter M.T. Pattynama, MD, PhD; Peter J.G. van de Ven, MD, PhD; Dammis Vroegindeweij, MD, PhD; Abraham A. Kroon, MD, PhD; Michiel W. de Haan, MD, PhD; Cornelis T. Postma, MD, PhD; and Jaap J. Beutler, MD, PhD* Background:Little is known about the efficacy and safety of renal artery stenting in patients with atherosclerotic renal artery stenosis (ARASand impaired renal function. Objective:To determine the efficacy and safety of stent placement in patients with ARAS and impaired renal function. Design:Randomized clinical trial. Randomization was centralized and computer generated, and allocation was assigned by e-mail. Patients, providers, and persons who assessed outcomes were not blinded to treatment assignment. Setting:10European medical centers. Participants:140patients with creatinine clearance less than 80 mL/minper 1.73m 2and ARAS of 50%or greater. Intervention:Stent placement and medical treatment (64patients or medical treatment only (76patients. Medical treatment con-sisted of antihypertensive treatment, a statin, and aspirin. Measurements:The primary end point was a 20%or greater decrease in creatinine clearance. Secondary end points included safety and cardiovascular morbidity and mortality. Results:Forty-six of 64patients assigned to stent placement had the procedure. Ten of the 64patients (16%in the stent placement group and 16patients (22%in the m