Effect of Renal Denervation on the Plasma Adipokines Concentrations in Patients With Resistant Arterial Hypertension

Objective: Adiponectin, leptin and visfatin are synthesized by adipocytes. Adiponectin has anti-diabetic, anti-atherosclerotic, anti-thrombotic, anti-inflammatory, and cardioprotective properties. Leptin has hypertensinogenic properties. Visfatin seems to be a useful marker of endothelial dysfunction and vascular damage. Renal denervation (RDN), is proposed as method of treatment in patients with resistant arterial hypertension. This single-center, interventional clinical study aimed to assess the effect of RDN on plasma adipokines (adiponectin, leptin and visfatin) concentration in patients with resistant arterial hypertension. Design and method: Eighteen patients (9 women, 9 men) aged 53.2±6.5 years with resistant arterial hypertension who underwent RDN using Simplicity catheters (Medtronic, Inc., Northridge, CA) were enrolled in the study. Plasma adiponectin, leptin and visfatin concentration was determined before and 6 months after RDN using: the Human Adiponectin ELISA Kit (Otsuka Pharmaceutical Co, Tokyo, Japan), the Human Leptin RIA HL-81K (Linco Research, Inc., Missouri, USA) and Visfatin c-terminal ELISA Kit (Phoenix Pharmaceuticals Inc., Karlsruche, Germany), respectively. Results: Systolic and diastolic blood pressure was reduced 6 months after RDN (mean ± standard deviation; 196.6±28.2 and 162.9±15.6; p<0.001 as well as 117.9±26.4 and 90.7±8.6 mmHg; p<0.001), respectively). Body mass index (BMI) before and 6 months after RDN was similar (mean ± standard deviation, 31.0 ± 4.4 and 31.3±4.4 kg/m2; p=0.8). Plasma adiponectin concentration increased significantly 6 months after RDN (median with interquartile range; 5.78 (3.70;10.47) and 7.58 (5.60;10.64) μg/mL, p=0.009). Plasma leptin and visfatin concentration measured before and 6 months after RDN did not change significantly (median with interquartile range; 5.78 (95% CI 27.5 (14.0;39.0) and 22.5 (12.0;32.0) ng/mL; p=0.13, as well as 4.45 (3.70;5.00) and 4.70 (4.10;6.00) ng/mL; p=0.23, before and 6 months after RDN, respectively). Conclusions: 1. Renal denervation which successfully decreases systolic and diastolic blood pressure may also increase plasma adiponectin concentration but did not influence plasma leptin and visfatin concentration in patients with resistant arterial hypertension. 2. Increased plasma adiponectin concentration may participate in the cardiovascular benefits in these patients, however long term clinical consequences of this observation need further investigations.