39 RENAL RESPONSES TO LONG-TERM CAROTID BAROREFLEX ACTIVATION IN PATIENTS WITH DRUG-RESISTANT HYPERTENSION

Abstract

Objective: Carotid baroreflex activation therapy (BAT) has previously been demonstrated to provide enduring reductions in arterial blood pressure. The aim of this study is to investigate the effect of long-term BAT on renal function. Methods: 322 patients were enrolled in the Rheos Pivotal Trial. Group 1 consisted of 236 patients who received BAT one month after device implantation. The 86 subjects comprising Group 2 received optimal drug treatment and started BAT 7 months after implantation. Blood and urine samples of creatinine, eGFR, and albumin-to-creatinine ratio (ACR) were collected at months 0 (before device activation), 6 and 12. Multilevel statistical analyses were corrected for reduction in systolic blood pressures (SBP) and number of antihypertensive medications at the different time points. Results: A significant although moderate increase in creatinine concentration and a decrease in eGFR were observed in Group 1 at months 6 and 12 compared to month 0 (Table 1). In Group 2 creatinine and eGFR changed significantly only at month 12 compared to month 0 after receiving 6 months of BAT. Only SBP reduction appeared to be a significant factor associated with the change in creatinine and eGFR. ACR showed no obvious changes in time. Conclusions: BAT in hypertensive patients is associated with an initial mild decrease in eGFR, which can be explained by the concomitant decrease in blood pressure. Long-term treatment does not result in further decrease in renal function, indicating BAT as a safe and effective therapy.