title: Does renal artery supply indicate treatment success of renal denervation?
abstract: OBJECTIVE
  Renal denervation (RDN) emerged as an innovative interventional antihypertensive therapy. With the exception of pretreatment blood pressure (BP) level, no other clear predictor for treatment efficacy is yet known. We analyzed whether the presence of multiple renal arteries has an impact on BP reduction after RDN.
  
  
  METHODS
  Fifty-three patients with treatment-resistant hypertension (office BP ≥ 140/90 mmHg and 24-h ambulatory BP monitoring (≥130/80 mmHg) underwent bilateral catheter-based RDN. Patients were stratified into one-vessel (OV) (both sides) and at least multivessel (MV) supply at one side. Both groups were treated on one vessel at each side; in case of multiple arteries, only the dominant artery was treated on each side.
  
  
  RESULTS
  Baseline clinical characteristics (including BP, age, and estimated glomerular filtration rate) did not differ between patients with OV (n = 32) and MV (n = 21). Office BP was significantly reduced in both groups at 3 months (systolic: OV -15 ± 23 vs. MV -16 ± 20 mmHg; diastolic: OV -10 ± 12 vs. MV -8 ± 11 mmHg, both p = NS) as well as 6 months (systolic: OV -18 ± 18 vs. MV -17 ± 22 mmHg; diastolic: OV -10 ± 10 vs. -10 ± 12 mmHg, both p = NS) after RDN. There was no difference in responder rate (rate of patients with office systolic BP reduction of at least 10 mmHg after 6 months) between the groups.
  
  
  CONCLUSIONS
  In patients with multiple renal arteries, RDN of one renal artery--namely, the dominant one--is sufficient to induce BP reduction in treatment-resistant hypertension.
authors.affiliation: Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054, Erlangen, Germany. axel.schmid@uk-erlangen.de
authors.forename: Axel
authors.initials: A
authors.lastname: Schmid
authors.forename: Tilmann
authors.initials: T
authors.lastname: Ditting
authors.forename: Paul A
authors.initials: PA
authors.lastname: Sobotka
authors.forename: Roland
authors.initials: R
authors.lastname: Veelken
authors.forename: Roland E
authors.initials: RE
authors.lastname: Schmieder
authors.forename: Michael
authors.initials: M
authors.lastname: Uder
authors.forename: Christian
authors.initials: C
authors.lastname: Ott
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001795:Blood Pressure Determination; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D003714:Denervation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D007668:Kidney / Q000098:blood supply* / Q000294:innervation / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000503:physiopathology / Q000601:surgery*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents