Objective: Increased blood pressure (BP) is a common finding in patients with autosomal dominant polycystic kidney disease (ADPKD), which is related to increased sympathetic nerve activity and is the predominant treatable factor to prevent endstage renal disease. Strict blood pressure control is mandatory to stop progression of the disease. Design and method: In this trial (Clingov: NCT05460169), patients with ADPKD (eGFR>40 ml/min/1.73 m2) and uncontrolled hypertension (Office B >130/>80mmHg and 24-h ambulatory BP>125/>75mmHg) despite 1-4 antihypertensive medications were enrolled. Patients were randomized to either the immediately treated group (I-group; N=23) or delayed-treatment group serving as control group (D-group; N=21). uRDN was performed using the PARADISE System (Recor Medical, Inc., USA). In this prespecified interim analysis, we examined the BP reduction (office, 24-hour ambulatory, and home) 3 months after uRDN. We also report the 6 months follow up data in the combined group-p (N=44). Results: The mean age of our patients with ADPKD (27 males and 17 females) was 42 years and their eGFR was 67 mL/min/1.73m2. Three months after uRDN, office and home systolic BP were significantly lower (and 24-hour ABP numerically lower) in the I-group than the D-group (Table 1). Considering all patients together, we observed significant reductions in office, home, and 24-hour ABP (systolic and diastolic) 3 and 6 months after uRDN compared to values prior to uRDN (Table 2). Adherence measurements found that roughly 80% were fully adherent to medication, and sensitivity analyses found consistent BP reductions. No safety signals related to uRDN were identified during the follow-up period.Conclusions: Clinically meaningful reductions in systolic and diastolic BP were observed at 3 months following uRDN in patients with ADPKD and uncontrolled hypertension without any safety concerns.
Schmieder et al. (Fri,) studied this question.