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Renal sympathetic denervation lowers BP up to 3 years after treatment
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The effect of renal sympathetic denervation on BP among patients with resistant hypertension persisted for up to 3 years after the procedure, according to recent results.
This reduction in BP after denervation was observed with no evidence of renal failure, even among patients with impaired renal function, indicating the long-term efficacy and safety of the procedure, the researchers wrote.
The study included data from 62 patients with resistant hypertension who underwent renal sympathetic denervation (33 men, 29 women; mean age, 68 years). Serum levels of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) were measured before denervation and at 24 hours, 48 hours and 3 months after the procedure. BP, use of antihypertensive drugs and incidence of adverse events were assessed during 3 years of follow-up, with a mean of 36.9 months of follow-up in 47 evaluable patients.
NGAL levels were 14.5 ng/mL at baseline, 14 ng/mL at 24 hours and 13.4 ng/mL at 48 hours after denervation; KIM-1 levels were 0.64 ng/mL, 0.54 ng/mL and 0.61 ng/mL, respectively.
Upon completion of follow-up, patients exhibited a mean 23 mm Hg reduction in systolic BP (159.1 mm Hg at baseline vs. 136.1 mm Hg at 3 years; P < .001). Evaluated biomarkers did not change significantly during the study, including serum creatinine (0.9 mg/dL vs. 0.96 mg/dL; P = .14), blood urea nitrogen (40 mg/dL vs. 41 mg/dL; P = .33) and estimated glomerular filtration rate (76.71 mL/min/1.73 m2 vs. 79.5 mL/min/1.73 m2; P = .2). The researchers also observed no significant difference in estimated glomerular filtration rate in a subgroup of patients with impaired renal function (40.2 mL/min/1.73 m2 vs. 48.8 mL/min/1.73 m2; P = .34).
The researchers wrote that their findings “[demonstrate] a sustained effect of [renal sympathetic denervation] on BP reduction after long-term follow-up of 3 years. In addition, [renal sympathetic denervation] does not aggravate functional or structural renal damage during the early post-procedural period, as reflected by the highly specific biomarkers NGAL and KIM-1. Moreover, there is no evidence of renal failure after long-term follow-up. Accordingly, the results of the present study provide additional verification of the long-term safety and effectiveness of [renal sympathetic denervation].” – by Adam Taliercio
Disclosure: The researchers report no relevant financial disclosures.
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