The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.
Feasibility of catheter-based renal nerve ablation and effects on sympathetic nerve activity and blood pressure in patients with end-stage renal disease
Abstract
Background and objectives Sympathetic activation is a hallmark of ESRD and adversely affects cardiovascular prognosis. Efferent sympathetic outflow and afferent neural signalling from the failing native kidneys are key mediators and can be targeted by renal denervation (RDN). Whether this is feasible and effective in ESRD is not known.Design, setting, participants and measurements In an initial safety and proof-of-concept study we attempted to perform RDN in 12 patients with ESRD and uncontrolled blood pressure (BP). Standardized BP measurements were obtained in all patients on dialysis free days at baseline and follow up. Measures of renal noradrenaline spillover and muscle sympathetic nerve activity were available from 5 patients at baseline and from 2 patients at 12 month follow up and beyond.Results Average office BP was 170.8 ± 16.9/89.2 ± 12.1 mmHg despite the use of 3.8 ± 1.4 antihypertensive drugs. All 5 patients in whom muscle sympathetic nerve activity and noradrenaline spillover was assessed at baseline displayed substantially elevated levels. Three out of 12 patients could not undergo RDN due to atrophic renal arteries. Compared to baseline, office systolic BP was significantly reduced at 3, 6, and 12 months after RDN (from 166 ± 16.0 to 148 ± 11, 150 ± 14, and 138 ± 17 mmHg, respectively), whereas no change was evident in the 3 non-treated patients. Sympathetic nerve activity was substantially reduced in 2 patients who underwent repeat assessment.Conclusions RDN is feasible in patients with ESRD and associated with a sustained reduction in systolic office BP. Atrophic renal arteries may pose a problem for application of this technology in some patients with ESRD.
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“To this point only two small pilot studies have been conducted, both uncontrolled but successful, in renal hypertension, and in end-stage renal disease107–108.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [108]
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Metadata
- Authors
- Schlaich, M. P., Bart, B., Hering, D., Walton, A., Marusic, P., Mahfoud, F., Böhm, M., Lambert, E. A., Krum, H., Sobotka, P. A., Schmieder, R. E., Ika-Sari, C., Eikelis, N., Straznicky, N., Lambert, G. W., & Esler, M. D.
- Affiliations
- Baker Heart and Diabetes Institute (AU)
- University of Minnesota (US)
- The Alfred Hospital (AU)
- Universitätsklinikum des Saarlandes (DE)
- Monash University (AU)
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- ORCID
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 168
- Issue
- 3
- Pages
- 2214-2220
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2065121034
- Cited by
- 155
- References
- 30
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 4 · 2023: 8 · 2022: 5 · 2021: 4 · 2020: 8 · 2019: 2 · 2018: 2 · 2017: 11 · 2016: 21 · 2015: 20 · 2014: 33 · 2013: 21
- FWCI
- 21.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- Funders
- Australian Government
- State Government of Victoria
- National Health and Medical Research Council
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Nephrology › Renal and Vascular Pathologies
- Keywords
- renal denervation, renal nerve ablation, end-stage renal disease, uncontrolled hypertension, blood pressure reduction, muscle sympathetic nerve activity, noradrenaline spillover, sympathetic nervous system, dialysis, cardiovascular risk
- MeSH terms
- Blood Pressure, Feasibility Studies, Female, Follow-Up Studies, Humans, Hypertension, Renal, Kidney, Kidney Failure, Chronic, Male, Middle Aged, Sympathectomy, Sympathetic Nervous System, Time Factors, Treatment Outcome, Catheter Ablation
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