Abstract 14312: Effect of Renal Denervation on Kidney Function Beyond Creatinine Clearence
AIM: Renal denervation (RDN) is a new therapeutic strategy for patients with resistant hypertension. However, the effects of this minimally invasive treatment modality on changes in renal blood flow, as well as tubular and glomerular function are incompletely understood.
METHODS: We enrolled 29 patients with resistant hypertension (16 male, 13 female). Inclusion criteria were a baseline systolic BP ≥160 mmHg (≥150 mmHg in diabetics), treated with ≥3 antihypertensive drugs, an estimated glomerular filtration rate ≥45 mL/min/1.73m2 and suitable renovascular anatomy. Medication was unchanged during the follow-up period. All patients underwent bilateral RDN. Systolic (SBP) and diastolic blood (DBP) pressures were measured at baseline and at the 6 months follow-up with an automated OMRON device. Renal segmental arterial resistance index (RI; the percentage reduction of the end-diastolic flow as compared with the systolic flow) was measured by Doppler ultrasonography. In addition, we quantified serum creatinine and excretion of urinary microproteins and IgG (24-hour urine collection) as markers for tubular and glomerular damage, respectively.
RESULTS: (all results are given in mean±SEM) Mean age was 55±8 years. Office SBP and DBP were reduced by −16±4 and −7±2 mmHg (p<0.01) after 6 months. Resistance index was unchanged comparing baseline and 6 months follow-up (right renal artery (RA): 0.69±0.07vs. 0.68±0.06, p=0.41; left RA: 0.69±0.06 vs. 0.70±0.08, p=0.32). Serum creatinine was stable (71±13 µmol/l vs. 74±16 µmol/l; p=0.22). Neither, alpha1- and beta2-microglobulin (tubular reabsorption), nor IgG (glomerular filtration) urinary excretion was different between baseline and follow-up after 6 months.
CONCLUSION: (i) Six months after RDN patients with resistant hypertension experienced a substantial reduction in SBP and PP . (ii) RDN did not affect intrarenal vascular resistance as assessed by RI. (iii) Furthermore, there is no evidence that RDN decreased tubular reabsorption or glomerular filtration. These data suggest, that during an observational period of 6 months, RDN is without harm for renal function.
- © 2012 by American Heart Association, Inc.