title: Renal sympathetic denervation in patients with hypertension and chronic kidney disease: does improvement in renal function follow blood pressure control?
abstract: Twenty-seven patients with resistant hypertension and chronic kidney disease were treated by renal sympathetic denervation (RSD) and followed for 12 months. Patients were retrospectively divided into controlled and uncontrolled blood pressure (BP) groups. Increases in mean estimated glomerular filtration rate (eGFR) were found at months 1, 3, 6, and 12 in the controlled group (P < .0001, for every time point). The mean change in eGFR after 12 months was 18.54 ± 8.15 mL/min/1.73 m(2) higher in the controlled group (P=.0318). In patients in the controlled group with baseline eGFR < 45 mL/min/1.73 m(2), responders (with an increase in eGFR > 6.2%) corresponded to 50% at 6 months and 83% at 12 months. In the patients with baseline eGFR ≥ 45 mL/min/1.73 m(2), all patients were labeled as responders at months 6 and 12. Median albumin:creatinine ratio after 12 months was lower than baseline only in the controlled group (P = .0003). Our results suggest that patients with this profile who reached BP control by RSD also experienced a significant improvement in renal function.
authors.affiliation: Renal Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Márcio Galindo
authors.initials: MG
authors.lastname: Kiuchi
authors.forename: Shaojie
authors.initials: S
authors.lastname: Chen
authors.forename: Bruno Rustum
authors.initials: BR
authors.lastname: Andrea
authors.forename: Tetsuaki
authors.initials: T
authors.lastname: Kiuchi
authors.forename: Maria Angela Magalhães de Queiroz
authors.initials: MA
authors.lastname: Carreira
authors.forename: Miguel Luis
authors.initials: ML
authors.lastname: Graciano
authors.forename: Jocemir Ronaldo
authors.initials: JR
authors.lastname: Lugon
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001795:Blood Pressure Determination; D003131:Combined Modality Therapy; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000601:surgery*; D007668:Kidney / Q000294:innervation*; D007677:Kidney Function Tests; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000601:surgery*; D012189:Retrospective Studies; D013562:Sympathectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents