title: Effects of renal denervation on end organ damage in hypertensive patients.
abstract: BACKGROUND
  Renal denervation (RDN) is believed to reduce sympathetic nerve activity and is a potential treatment for resistant hypertension. The present study investigated the effects of RDN on end organ damage (EOD).
  
  
  METHODS
  The present study was a prospective cohort study (registered as NCT01427049).
  
  
  METHODS
  Uncontrolled hypertensive patients underwent a work-up prior to and one year after RDN. Cardiac magnetic resonance (CMR) imaging was used to determine left ventricular (LV)-mass; pulse wave analysis and pulse wave velocity (PWV) were used for evaluation of central blood pressure (BP) and arterial stiffness and 24-hour urine was collected for assessment of urinary albumin excretion. The 24-hour ambulatory BP measurement (ABPM) was used to evaluate the effect of RDN on BP.
  
  
  RESULTS
  Fifty-four patients gave informed consent for study participation. Mean age was 58 ± 10 years, 50% were male. One year after RDN, mean ABPM decreased by 7 ± 18/5 ± 11 mm Hg (p = 0.01/p < 0.01). In the patients followed-up in a standardised fashion ABPM decreased by 5 ± 18/4 ± 12 mm Hg (n = 34; p = 0.11/p = 0.09). Mean body surface area indexed LV-mass decreased by 3.3 ± 11.5 g/m(2) (corresponding to a 3 ± 11% reduction; p = 0.09). PWV increased by 2.9 (-2.2 to +6.1) m/s (p = 0.04). Augmentation index corrected for 75 beats per min did not change (median increase 3.0 (-7 to +17) mm Hg; p = 0.89). Urinary albumin excretion did not change during follow-up (mean decrease 10 ± 117 mg/24 hour; p = 0.61).
  
  
  CONCLUSIONS
  In the current study, we observed a modest effect from renal denervation. Moreover, RDN did not result in a statistical significant effect on end organ damage 12 months after treatment.
authors.affiliation: Department of Cardiology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Willemien L
authors.initials: WL
authors.lastname: Verloop
authors.affiliation: Department of Nephrology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Eva E
authors.initials: EE
authors.lastname: Vink
authors.affiliation: Department of Vascular Medicine, University Medical Center, Utrecht, the Netherlands.
authors.forename: Wilko
authors.initials: W
authors.lastname: Spiering
authors.affiliation: Department of Nephrology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Blankestijn
authors.affiliation: Department of Cardiology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Pieter A
authors.initials: PA
authors.lastname: Doevendans
authors.affiliation: The Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
authors.affiliation: Department of Radiology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Evert-jan
authors.initials: EJ
authors.lastname: Vonken
authors.affiliation: Department of Cardiology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Michiel
authors.initials: M
authors.lastname: Voskuil
authors.affiliation: Department of Radiology, University Medical Center, Utrecht, the Netherlands t.leiner@umcutrecht.nl.
authors.forename: Tim
authors.initials: T
authors.lastname: Leiner
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000652:urine; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination; D003714:Denervation / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007668:Kidney / Q000000981:diagnostic imaging / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D011859:Radiography; D012079:Renal Circulation; D013562:Sympathectomy / Q000379:methods; D013564:Sympathetic Nervous System / Q000601:surgery; D059289:Vascular Stiffness / Q000502:physiology
keywords: Renal denervation; albuminuria; arterial stiffness; end organ damage; left ventricular hypertrophy