Ott C, Mahfoud F, Schmid A, Toennes SW, Ewen S, Ditting T, Veelken R, Ukena C, Uder M, Boehm M, Schmieder R (2015)
Publication Type: Journal article
Publication year: 2015
Book Volume: 33
Pages Range: 1261-6
Journal Issue: 6
DOI: 10.1097/HJH.0000000000000556
Arterial hypertension and increased sympathetic activity are underlying pathogenetic mechanisms of the progressive loss of renal function in patients with chronic kidney disease (CKD). Meta-analyses have shown that impaired renal function is an independent cardiovascular risk factor. We hypothesized that renal denervation (RDN) decreases the decline of renal function in patients with CKD stages 3 and 4 and treatment-resistant hypertension.We performed an observational study of 27 patients with CKD stages 3 and 4, office blood pressure (BP) >= 140/90 mmHg, while on at least three antihypertensive drug classes including diuretic, and diagnosis confirmed by 24-h ambulatory BP measurement >= 130/80 mmHg. All patients underwent catheter-based RDN using the Symplicity Flex RDN System (Medtronic Inc., Santa Rosa, California, USA). Renal function was evaluated for up to 3 years prior and 1 year after RDN. The change in estimated glomerular filtration rate (eGFR) was calculated by regression slope individually for each patient before and after RDN. The study was registered at http://www.clinicaltrials.gov (ID: NCT01442883).Mean baseline BP was 156 ± 12/82 ± 13 mmHg, despite treatment with 6.2 ± 1.1 antihypertensive drugs. One year after RDN, office BP was reduced by 20 ± 20 (P < 0.001)/8 ± 14 mmHg (P = 0.005) and average 24-h ambulatory BP by 9 ± 14 (P = 0.009)/4 ± 7 mmHg (P = 0.019). Before RDN, eGFR declined by -4.8 ± 3.8 ml/min per 1.73 m per year, and after RDN eGFR improved by +1.5 ± 10 ml/min per 1.73 m at 12 months (P = 0.009).Our observational pilot study in patients with CKD stages 3 and 4 indicates that treatment of hypertension with RDN decreases BP and slows or even halts the decline of renal function.
APA:
Ott, C., Mahfoud, F., Schmid, A., Toennes, S.W., Ewen, S., Ditting, T.,... Schmieder, R. (2015). Renal denervation preserves renal function in patients with chronic kidney disease and resistant hypertension. Journal of Hypertension, 33(6), 1261-6. https://doi.org/10.1097/HJH.0000000000000556
MLA:
Ott, Christian, et al. "Renal denervation preserves renal function in patients with chronic kidney disease and resistant hypertension." Journal of Hypertension 33.6 (2015): 1261-6.
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