Key result
Catheter-based renal denervation significantly reduced blood pressure, urine albumin, serum NE, AngII, and fibrotic tissue compared with sham surgery in a canine model of hypertension (all p < 0.05).
Why the study?
It was unknown whether catheter-based renal denervation could reduce kidney fibrosis and halt the progression of renal impairment in high-fat diet-induced hypertension.
Does catheter-based renal denervation reduce kidney fibrosis and halt the progression of renal impairment in a canine model of high-fat diet-induced hypertension?
RCT (n=32)
randomized
Does catheter-based renal denervation reduce kidney fibrosis and halt the progression of renal impairment in a canine model of high-fat diet-induced hypertension?
p-value: p=<0.05
Catheter-based renal denervation reduces blood pressure, slows albuminuria progression, and suppresses renal remodeling in a canine model of high-fat diet-induced hypertension.
May attenuate hypertensive renal remodeling in models; leaves open translation to human CKD trials.
BACKGROUND/AIMS: Catheter-based renal denervation (RDN) has emerged as an innovative interventional approach for reducing blood pressure (BP), suppressing ventricular substrate remodeling, and attenuating heart failure, which suggests that it might reduce kidney fibrosis in a canine model of high-fat diet-induced hypertension. This study thus sought to assess whether RDN could reduce kidney fibrosis and halt the progression of renal impairment in a canine model of high-fat diet-induced hypertension. METHODS: Thirty-two beagles were randomized into either the normal control group (normal diet, n = 10) or the hypertension group (high-fat diet, n = 22). After successful establishment of the model, the hypertension model group was randomized to either the RDN group (n = 9) or the sham-surgery group (n = 8). Renal artery angiography, BP, heart rate (HR), and blood and urine biochemistry results were assessed at 1, 3, and 6 months after surgery. Canines were sacrificed at 6 months after surgery. The extent of kidney interstitial fibrosis, transforming growth factor-beta 1, alpha-smooth muscle actin, connective tissue growth factor, and E-cadherin protein were measured. RESULTS: The group fed a high-fat diet had significantly (p ˂ 0.05) increased body weight, BP, and HR and higher levels of urine albumin, serum noradrenaline (NE), and angiotensin II (AngII) than the control group. The sham-surgery group and RDN group also had higher levels than the control group (p ˂ 0.05). Compared with the sham-surgery group, the RDN group had lower BP, urine albumin, serum NE, and AngII and less fibrotic tissue (all p ˂ 0.05). CONCLUSION: RDN reduced BP, slowed progression of albuminuria, and suppressed renal remodeling in a canine model of high-fat diet-induced hypertension.
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Gong et al. (2019) conducted an RCT in high-fat diet-induced hypertension (n=32). Catheter-based renal denervation (RDN) vs. sham-surgery was evaluated on BP, urine albumin, serum NE, AngII, and fibrotic tissue (p=<0.05). Catheter-based renal denervation significantly reduced blood pressure, urine albumin, serum NE, AngII, and fibrotic tissue compared with sham surgery in a canine model of hypertension (all p < 0.05).
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