Renal denervation in patients with versus without chronic kidney disease: results from the global SYMPLICITY Registry with follow-up data of 3 years.
Abstract
Activity of the sympathetic nervous system is increased in patients with hypertension and chronic kidney disease (CKD). Here we compare short- and long-term blood pressure (BP) lowering effects of renal denervation (RDN) between hypertensive patients with or without CKD in the Global SYMPLICITY Registry. Office and 24-hour ambulatory BP (ABP) were assessed at pre-specified time-points after RDN. The presence of CKD was defined according to estimated glomerular filtration rate (eGFR), and enrolled patients were stratified based on the presence (N = 475, eGFR < 60 ml/min/1.73m2) or absence (N = 1505, eGFR ≥ 60ml/min/1.73m2) of CKD. Patients with CKD were older (p < 0.001) and were prescribed more antihypertensive medications (p < 0.001). eGFR-decline/year was not significantly different between groups after the first year. Office and 24-hour ABP were significantly reduced from baseline at all timepoints after RDN in both groups (all p < 0.001). After adjusting for baseline data, patients without CKD had a greater reduction in office systolic BP (-17.3 ± 28.3 vs. -11.7 ± 29.9 mmHg, p = 0.009), but not diastolic BP at 36 months compared to those with CKD. Similar BP and eGFR-results were found when the analysis was limited to patie...Continue Reading
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