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Original Research

Open Access

Renal denervation in patients with resistant hypertension - single centre report

  • INGRID PRKAČIN1,2
  • GORDANA CAVRIĆ1
  • BORNA VRHOVEC1
  • ANA LEGOVIĆ1
  • PETRA DRAŽIĆ1
  • VESNA ĐERMANOVIĆ DOBROTA1
  • IVA BORAS1
  • VINKO VIDJAK2,3

1Department of Internal Medicine, University Hospital Merkur, Zagreb, Croatia

2Zagreb University School of Medicine, Zagreb, Croatia

3Department of Radiology, Merkur Clinical Hospital, Zagreb, Croatia

DOI: 10.22514/SV101.062015.8 Vol.10,Issue S1,June 2015 pp.32-34

Published: 22 June 2015

*Corresponding Author(s): INGRID PRKAČIN E-mail: ingrid.prkacin@gmail.com

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Abstract

Among patients with resistant hyperten-sion, it is very important to select patients most likely to benefit from renal sympa-thetic denervation, because they represent a very mixed group of diagnoses. 

Prior to diagnosing a patient as having resistant hypertension, it is important to document adherence and exclude white-coat hypertension, inaccurate measure-ments of blood pressure and secondary causes of hypertension. 

Renal sympathetic denervation has been demonstrated as an antihypertensive treat-ment in resistant hypertension patients with additional positive effects on glucose metabolism and insulin sensitivity in type 2 diabetes. 

We report a single centre report of renal sympathetic denervation effects in a small cohort of patients with resistant hyperten-sion and stage 2-3 chronic kidney disease. Blood pressure reduction after renal sym-pathetic denervation was sustained at con-secutive follow-up visits one, three and six months when compared to the baseline: office systolic blood pressure was signifi-cantly lower (144 ± 13, 140 ± 17, 141 ± 15 mmHg, p<0.001). 

Randomized clinical trials are required to assess the impact of the reported changes. 

Keywords

resistant hypertension, stepwise screening protocol, renal denervation

Cite and Share

INGRID PRKAČIN,GORDANA CAVRIĆ,BORNA VRHOVEC,ANA LEGOVIĆ,PETRA DRAŽIĆ,VESNA ĐERMANOVIĆ DOBROTA,IVA BORAS,VINKO VIDJAK. Renal denervation in patients with resistant hypertension - single centre report. Signa Vitae. 2015. 10(S1);32-34.

URL:

https://www.signavitae.com/articles/10.22514/SV101.062015.8

References

1. Mahfoud F, Schlaich M, Kindermann I, et al. Effect of renal sympathetic denervation on glucose metabolism in patients with resist-ant hypertension: a pilot study. Circulation 2011;123:1940-6

2. Witkowski A, Prejbisz A, Florczak E et al. Effects of renal sympathetic denervation on blood pressure, sleep apnea course, and glycemic control in patients with resistant hypertension and sleep apnea. Hypertension. 2011; 58: 559–565.

3. Hering D, Mahfoud F, Walton AS, et al. Renal denervation in moderate to severe CKD. J Am Soc Nephrol 2012; 23:1250-7.

4. Prkačin I, Ožvald I, Cavrić G, Balenović D, Bulum T, Flegar-Meštrić Z. Importance of urinary NGAL, serum creatinine standardi-zation and estimated glomerular filtration rate in resistant hypertension. Coll Antropol 2013; 37 (3): 821-825.

5. Hering D, Esler MD, Schlaich MP. Chronic kidney disease: role of sympathetic nervous system activation and potential benefits of renal denervation. EuroIntervention 2013; 9 (Suppl R): R127-35.

6. Hermida RC, Ayala DE, Portaluppi F. Circadial variation of blood presuure: the basis for the chronotherapy of hypertension. Adv  Drug Deliv Rev 2007; 59:904-922. 

7. de Jager RL, Blankestijn PJ. Pathophysiology I: the kidney and the sympathetic nervous system. Euro Intervention 2013; 9 (Suppl R): R42-7.

8. Papademetriou V, Tsioufis C, Doumas M. Renal Denervation and Symplicity HTN-3: „Dubiom Sapientiae Initium“ (Doubt is the Beginning of Wisdom). Circ Res 2014; 115 (Supl. 2): 211-214.

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