Renal Denervation in Patients With Moderate to Severe Chronic Kidney Disease

BACKGROUND: Uncontrolled hypertension is common in patients with chronic kidney disease (CKD), putting these patients at high risk for adverse cardiovascular events. Radiofrequency renal denervation (RDN) lowers blood pressure (BP) in patients with hypertension. The Global SYMPLICITY Registry DEFINE enrolled over 3500 patients with uncontrolled hypertension worldwide, including patients with moderate-to-severe CKD. METHODS: ): eGFR ≥60 (no-CKD, n=2539), eGFR ≥45 to <60 (stage 3a, n=496), eGFR ≥30 to <45 (stage 3b, n=256). BP changes from baseline through 3 years were compared between groups. One-year data for 74 CKD stage 4 patients were also assessed. Safety events and eGFR were reported at all time points. RESULTS: =0.007). CONCLUSIONS: In patients with uncontrolled hypertension and moderate-to-severe CKD, radiofrequency RDN results in clinically meaningful and durable BP reduction without renal or vascular safety concerns. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01534299.