Key result
Patients with resistant hypertension and chronic kidney disease who achieved blood pressure control after renal sympathetic denervation had a significantly greater increase in eGFR (18.54 mL/min/1.73m2 higher) at 12 months compared to those with uncontrolled blood pressure.
Why the study?
Does renal sympathetic denervation improve estimated glomerular filtration rate in patients with refractory hypertension and chronic kidney disease?
Observational (n=27)
Yes
Does renal sympathetic denervation improve estimated glomerular filtration rate in patients with refractory hypertension and chronic kidney disease?
Renal sympathetic denervation may improve renal function in patients with refractory hypertension and chronic kidney disease who successfully achieve blood pressure control.
BP control after RDN was associated with greater eGFR gains in resistant HTN-CKD; hypothesis-generating and requires randomized trials before practice change.
Twenty-seven patients with resistant hypertension and chronic kidney disease were treated by renal sympathetic denervation (RSD) and followed for 12 months. Patients were retrospectively divided into controlled and uncontrolled blood pressure (BP) groups. Increases in mean estimated glomerular filtration rate (eGFR) were found at months 1, 3, 6, and 12 in the controlled group (P < .0001, for every time point). The mean change in eGFR after 12 months was 18.54 ± 8.15 mL/min/1.73 m(2) higher in the controlled group (P=.0318). In patients in the controlled group with baseline eGFR < 45 mL/min/1.73 m(2), responders (with an increase in eGFR > 6.2%) corresponded to 50% at 6 months and 83% at 12 months. In the patients with baseline eGFR ≥ 45 mL/min/1.73 m(2), all patients were labeled as responders at months 6 and 12. Median albumin:creatinine ratio after 12 months was lower than baseline only in the controlled group (P = .0003). Our results suggest that patients with this profile who reached BP control by RSD also experienced a significant improvement in renal function.
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Kiuchi et al. (2014) conducted an observational in Resistant hypertension and chronic kidney disease (n=27). Controlled blood pressure after renal sympathetic denervation vs. Uncontrolled blood pressure after renal sympathetic denervation was evaluated on Mean change in estimated glomerular filtration rate (eGFR) at 12 months (MD 18.54, p=0.0318). Patients with resistant hypertension and chronic kidney disease who achieved blood pressure control after renal sympathetic denervation had a significantly greater increase in eGFR (18.54 mL/min/1.73m2 higher) at 12 months compared to those with uncontrolled blood pressure.
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