Open AccessLong‐Term Effects of Renal Sympathetic Denervation on Hypertensive Patients With Mild to Moderate Chronic Kidney Disease
Author(s) -
Kiuchi Márcio Galindo,
Graciano Miguel Luis,
Carreira Maria Angela Magalhães de Queiroz,
Kiuchi Tetsuaki,
Chen Shaojie,
Lugon Jocemir Ronaldo
Publication year - 2016
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12724
Subject(s) - medicine , interquartile range , renal function , kidney disease , ambulatory blood pressure , blood pressure , creatinine , urology , ambulatory
Thirty patients who underwent percutaneous renal denervation, which was performed by a single operator following the standard technique, were enrolled in this study. Patients with chronic kidney disease ( CKD ) stage 2 (n=19), 3 (n=6), and 4 (n=5) were included. Data were obtained at baseline and at monthly intervals for the first 6 months. At 7 months, follow‐up data were collected bimonthly until month 12, after which data were collected on a quarterly basis. Baseline blood pressure values (mean± standard deviation ) were 185±18/107±13 mm Hg in the office and 152±17/93±11 mm Hg through 24‐hour ambulatory blood pressure monitoring ( ABPM ). Three patients with stage 4 CKD required chronic renal replacement therapy (one at the 13‐month follow‐up and two at the 14‐month follow‐up) after episodes of acute renal injury; their follow‐up was subsequently discontinued. The office blood pressure values at the 24‐month follow‐up were 131±15/87±9 mm Hg ( P <.0001, for both comparisons); the corresponding ABPM values were 132±14/84±12 mm Hg ( P <.0001, for both comparisons). The mean estimated glomerular filtration rate increased from 61.9±23.9 mL /min/1.73 m 2 to 88.0±39.8 mL /min/1.73 m 2 ( P <.0001). The urine albumin:creatinine ratio decreased from 99.8 mg/g ( interquartile range, 38.0–192.1) to 11.0 mg/g ( interquartile range, 4.1–28.1; P <.0001 mg/g). At the end of the follow‐up period, 21 patients (70% of the initial sample) were no longer classified as having CKD.