Abstract 17215: Renal Hemodynamics and Renal Function After Catheter-Based Renal Sympathetic Denervation in Patients with Resistant Hypertension
Background Increased renal resistive index (RRI) and urinary albumin excretion (UAE) are markers of hypertensive end-organ damage involving increased sympathetic activity. Catheter-based renal sympathetic denervation (RD) offers a new approach to reduce renal activation of the sympathetic nervous system and blood pressure in resistant hypertension. The influence of RD on renal hemodynamics, renal function, and UAE has not been studied.
Methods and Results One hundred consecutive patients with resistant hypertension were included in the study; 88 underwent interventional RD and 12 served as controls. Systolic, diastolic and pulse pressure (SBP/DBP/PP) as well RRI in interlobar arteries, renal function and UAE were measured prior to, and at 3 and 6 months follow-up. RD reduced SBP, DBP and PP at 3 and 6 months by 22.7/26.6 mmHg, 7.7/9.7 mmHg, and 15.1/17.5 mmHg (p for all <0.001), respectively, without significant changes in the control group. SBP reduction after 6 months correlated to SBP baseline values (r = -0.46, p<0.001). There were no renal artery stenosis, dissections or aneurysms on follow-up. RRI decreased from 0.691 ± 0.01 at baseline to 0.674 ± 0.01 and 0.670 ± 0.01 (p=0.037/0.017) at 3- and 6-month follow-up, respectively. Mean Cystatin C glomerular filtration rate (GFR) and UAE remained unchanged after RD, however, the number of patients with micro- or macroalbuminuria decreased.
Conclusion Renal denervation reduced blood pressure, renal resistive index and incidence of albuminuria, without adversely affecting GFR or renal artery structure within 6 months. RD appears to be a safe and effective therapeutic approach to lower blood pressure in patients with resistant hypertension and is associated with favorable effects on renal hemodynamics and urinary albumin excretion rate.
- © 2012 by American Heart Association, Inc.