Why the study?
The blood pressure response to arterial renal denervation is variable, prompting evaluation of renal pelvic denervation.
Does renal pelvic denervation reduce blood pressure and norepinephrine levels in a porcine model?
Does renal pelvic denervation reduce blood pressure and norepinephrine levels in a porcine model?
Renal pelvic denervation demonstrates significant and sustained reductions in blood pressure and renal norepinephrine levels in a porcine model, highlighting a promising target for hypertension treatment.
Should not yet change practice; leaves open whether pelvic denervation can deliver more consistent RDN than arterial approaches.
INTRODUCTION: The blood pressure (BP) response to arterial renal denervation (RDN) is variable. METHODS: This study examined the effectiveness of renal pelvic denervation (RPD) on BP, heart rate (HR), norepinephrine (NE), and histopathology in 42 swine. NE levels were measured immediately, 7, 14, 30, and 90 days after RPD. Intra-arterial BP and HR were measured throughout RPD and after 14 days in 5 swine. RESULTS: During the procedure, RPD immediately reduced systolic BP (-20.6 ± 18.3 mm Hg), diastolic BP (-6.0 ± 8.3 mm Hg), and HR (-5.4 ± 5.6 bpm), which remained decreased at follow-up. The porcine kidneys had a mean NE reduction of 76% directly post procedure and 60% after 7 days, 64% after 14 days, 57% after 30 days, and 65% after 90 days. Histopathological examination confirmed nerve ablation. CONCLUSIONS: These preliminary findings suggest that the renal pelvis nerve ablation is an encouraging target for RDN. Clinical trials are required to test the feasibility of RPD in human hypertension.
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Hering et al. (2021) studied this question.
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