Effect of renal denervation on glucose metabolism in hypertensive patients with and without chronic kidney disease

Bytyqi V, Kannenkeril D, Schmid A, Striepe K, Bosch A, Karg MV, Schiffer M, Uder M, Schmieder R (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Clinical Kidney Journal Oxford University Press

Book Volume: 18

Article Number: sfaf184

Journal Issue: 7

DOI: 10.1093/ckj/sfaf184

Abstract

Backgroun:Sympathetic overactivation is associated with numerous pathologies, including arterial hypertension, diabetes, metabolic syndrome and chronic kidney disease (CKD). Renal denervation (RDN) has emerged as an adjacent therapy for the management of hypertension. By modulating sympathetic activity in the whole body, RDN has shown conflicting results regarding insulin secretion and glucose homeostasis. The aim of this study is to analyse the impact of RDN on glycaemic control in patients with CKD. Methods. A total of 155 hypertensive patients with (n = 45) or without CKD (n = 110) were included in this post hoc analysis. All patients underwent radiofrequency-, ultrasound- or alcohol injection-based RDN. Fasting plasma glucose (FPG) and haemoglobin A1c levels were measured at baseline, 3 months and 6 months after RDN in parallel with the office and 24-h ambulatory blood pressure. CKD was defined either by clinical diagnosis, an estimated glomerular filtration rate (eGFR) of 15-59 ml/min/1.73 m² and/or A2/A3 albuminuria in hypertensive patients, repeatedly confirmed, or several of these criteria. Results. In the total study cohort, FPG decreased by 5.1 ± 29.1 mg/dl (P =. 032) and by 7.9 ± 32.7 mg/dl (P =. 003) at 3 and 6 months after RDN, respectively. The change in FPG levels was related to the change in 24-h systolic BP (r = 0.286, P =. 008) 3 months after RDN. Among patients with CKD, FPG levels decreased by 13.5 ± 43.5 mg/dl at 3 months (P =. 043) and by 17.1 ± 45.2 mg/dl at 6 months (P =. 015) following RDN. These reductions were greater compared with the non-CKD group (P =. 021 and P =. 024, respectively). After excluding patients on oral antidiabetic or insulin therapy, patients with CKD (but not those without CKD) exhibited a reduction in FPG levels of 6.7 ± 15.3 mg/dl (P =. 043) at 6 months post-RDN. No significant changes were observed in eGFR in either group. Conclusion. We observed that FPG levels improved to a greater extent in hypertensive patients with CKD after RDN. Thus RDN may have a broader therapeutic impact beyond blood pressure reduction in CKD patients.

Authors with CRIS profile

Dennis Kannenkeril Department of Medicine 4 – Nephrology and Hypertension Axel Schmid Institute of Radiology Kristina Striepe Department of Medicine 4 – Nephrology and Hypertension Agnes Bosch Department of Medicine 4 – Nephrology and Hypertension Mario Schiffer Lehrstuhl für Innere Medizin IV Michael Uder Lehrstuhl für Diagnostische Radiologie Roland Schmieder Professur für Innere Medizin (Nephrologie)

How to cite

APA:

Bytyqi, V., Kannenkeril, D., Schmid, A., Striepe, K., Bosch, A., Karg, M.V.,... Schmieder, R. (2025). Effect of renal denervation on glucose metabolism in hypertensive patients with and without chronic kidney disease. Clinical Kidney Journal, 18(7). https://doi.org/10.1093/ckj/sfaf184

MLA:

Bytyqi, Venera, et al. "Effect of renal denervation on glucose metabolism in hypertensive patients with and without chronic kidney disease." Clinical Kidney Journal 18.7 (2025).

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