title: Long-Term Effects of Renal Sympathetic Denervation on Hypertensive Patients With Mild to Moderate Chronic Kidney Disease.
abstract: 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.
authors.affiliation: Renal Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.|Hospital Regional Darcy Vargas, Rio Bonito, RJ, Brazil.
authors.forename: Márcio Galindo
authors.initials: MG
authors.lastname: Kiuchi
authors.affiliation: Renal Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Miguel Luis
authors.initials: ML
authors.lastname: Graciano
authors.affiliation: Renal Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Maria Angela Magalhães de Queiroz
authors.initials: MA
authors.lastname: Carreira
authors.affiliation: Hospital Regional Darcy Vargas, Rio Bonito, RJ, Brazil.
authors.forename: Tetsuaki
authors.initials: T
authors.lastname: Kiuchi
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.|European Heart Rhythm Association/European Society of Cardiology, Department of Cardiology, Elisabethinen University Teaching Hospital Linz, Linz, Austria.
authors.forename: Shaojie
authors.initials: S
authors.lastname: Chen
authors.affiliation: Renal Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Jocemir Ronaldo
authors.initials: JR
authors.lastname: Lugon
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000652:urine; D001795:Blood Pressure Determination; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000503:physiopathology* / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology* / Q000652:urine*; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome