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Renal Hemodynamics and Renal Function After Catheter-Based Renal Sympathetic Denervation in Patients With Resistant Hypertension
Abstract
Increased renal resistive index and urinary albumin excretion are markers of hypertensive end-organ damage and renal vasoconstriction involving increased sympathetic activity. Catheter-based sympathetic renal denervation (RD) offers a new approach to reduce renal sympathetic activity and blood pressure in resistant hypertension. The influence of RD on renal hemodynamics, renal function, and urinary albumin excretion has not been studied. 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, as well renal resistive index in interlobar arteries, renal function, and urinary albumin excretion, were measured before and at 3 and 6 months of follow-up. RD reduced systolic, diastolic, and pulse pressure at 3 and 6 months by 22.7/26.6 mm Hg, 7.7/9.7 mm Hg, and 15.1/17.5 mm Hg ( P for all <0.001), respectively, without significant changes in the control group. SBP reduction after 6 months correlated with SBP baseline values ( r =−0.46; P <0.001). There were no renal artery stenoses, dissections, or aneurysms during 6 months of follow-up. Renal resistive index 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. Mean cystatin C glomerular filtration rate and urinary albumin excretion remained unchanged after RD; however, the number of patients with microalbuminuria or macroalbuminuria decreased. RD reduced blood pressure, renal resistive index, and incidence of albuminuria without adversely affecting glomerular filtration rate or renal artery structure within 6 months and appears to be a safe and effective therapeutic approach to lower blood pressure in patients with resistant hypertension.
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“Several open-label trials have documented the efficacy of renal denervation in subjects with resistant hypertension many of whom are obese (24–28).”
From Obesity-Associated Hypertension: Recent Progress in Deciphering the Pathogenesis (2014) · cites this paper as [27]
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Metadata
- Authors
- Mahfoud, F., Cremers, B., Janker, J., Link, B., Vonend, O., Ukena, C., Linz, D., Schmieder, R., Rump, L. C., Kindermann, I., Sobotka, P. A., Krum, H., Scheller, B., Schlaich, M., Laufs, U., & Böhm, M.
- Affiliations
- Baker Heart and Diabetes Institute (AU)
- ORCID
- Venue
- Hypertension
- Published
- 2012-08
- Volume
- 60
- Issue
- 2
- Pages
- 419-424
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2122826224
- Cited by
- 303
- References
- 33
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 4 · 2023: 11 · 2022: 6 · 2021: 9 · 2020: 5 · 2019: 7 · 2018: 14 · 2017: 18 · 2016: 31 · 2015: 39 · 2014: 56 · 2013: 83 · 2012: 11
- FWCI
- 38.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Nephrology › Renal and Vascular Pathologies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- renal denervation, resistant hypertension, renal hemodynamics, renal resistive index, urinary albumin excretion, albuminuria, glomerular filtration rate, cystatin C, blood pressure reduction, interlobar arteries, renal vasoconstriction, hypertensive end-organ damage
- MeSH terms
- Albuminuria, Blood Pressure, Drug Resistance, Female, Follow-Up Studies, Glomerular Filtration Rate, Hemodynamics, Humans, Hypertension, Kidney, Kidney Function Tests, Male, Middle Aged, Sympathectomy, Incidence, Treatment Outcome, Cystatin C, Catheters
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