Renal Denervation in Moderate to Severe CKD

Journal of the American Society of Nephrology, 05/18/2012

Hering D et al. – This study suggests a favorable short–term safety profile and beneficial BP effects of catheter–based renal nerve ablation in patients with stage 3–4 CKD and resistant hypertension.

Methods

  • The authors performed bilateral renal denervation in 15 patients with resistant hypertension and stage 3–4 CKD (mean eGFR, 31 ml/min per 1.73 m2).
  • The authors used CO2 angiography in six patients to minimize exposure to contrast agents.
  • Estimated GFR remained unchanged after the procedure, irrespective of the use of CO2 angiography.

Results

  • Mean baseline BP ± SD was 174±22/91±16 mmHg despite the use of 5.6±1.3 antihypertensive drugs.
  • Mean changes in office systolic and diastolic BP at 1, 3, 6, and 12 months were –34/–14, –25/–11, –32/–15, and –33/–19 mmHg, respectively.
  • Night–time ambulatory BP significantly decreased (P<0.05), restoring a more physiologic dipping pattern.

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