期刊
EUROPEAN HEART JOURNAL
卷 34, 期 28, 页码 2114-2121出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/eht200
关键词
Hypertension; Chronic kidney disease; Renal denervation; Blood pressure reduction; Improvement of renal function
资金
- programme of development of the Hospital Regional Darcy Vargas
Aims Evaluation of the safety and efficacy of renal denervation with a standard irrigated cardiac ablation catheter (SICAC) in chronic kidney disease (CKD) patients with refractory hypertension. Methods and results Twenty-four patients were included and treated with a SICAC. Denervation was performed by a single operator following the standard technique. Patients included with CKD were on stages 2 (n = 16), 3 (n = 4), and 4 (n = 4). Data were obtained at baseline and monthly until 180th day of follow-up. Baseline values of blood pressure (mean +/- SD) were 186 +/- 19 mmHg/108 +/- 13 mmHg in the office, and 151 +/- 18 mmHg/92 +/- 11 mmHg by 24 h ambulatory blood pressure monitoring (ABPM). Office blood pressure values at 180th day after the procedure were 135 +/- 13 mmHg/88 +/- 7 mmHg (P < 0.0001, for both comparisons). The mean ABPM decreased to 132 +/- 15 mmHg/85 +/- 11 mmHg at the 180th day after the procedure (P < 0.0001 for systolic and P = 0.0015 for diastolic). Estimated glomerular filtration (mean +/- SD) increased from baseline (64.4 +/- 23.9 mL/min/1.73 m(2)) to the 180th day (85.4 +/- 34.9 mL/min/1.73 m(2), P < 0.0001) of follow-up. The median urine albumin: creatinine ratio decreased from baseline (48.5, IQR: 35.8-157.2 mg/g) to the 180th day after ablation (ACR = 15.7, IQR: 10.3-34.2 mg/g, P = 0.0017). No major complications were seen. Conclusion The procedure using SICAC seemed to be feasible, effective, and safe resulting in a better control of BP, a short-term increase in estimated glomerular filtration rate, and reduced albuminuria. Although encouraging, our data are preliminary and need to be validated in the long term.
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