Abstract
Baroreflex activation therapy (BAT) is approved for the treatment of resistant hypertension. In addition to blood pressure (BP) reduction, pilot studies suggested several organoprotective effects of BAT. Thirty-two patients with resistant hypertension were prospectively treated with BAT. Besides office BP and 24-hour ambulatory BP (ABP) measurements, detection of a urinary proteome-based classifier (CKD273), which has been shown to predict chronic kidney disease (CKD) progression, was carried out at baseline and after 6months of BAT. Office BP significantly decreased from 170±25/90±18 to 149±29/82±18mmHg. Analysis of CKD273 score and eGFR with CKD-EPI equation at baseline revealed strong correlation (r=0.568, P<0.001). After 6months of BAT, there was no significant change in CKD273 score (-0.061 [95% CI: -0.262 to 0.140], P=0.601). However, by stratification of the data regarding ABP response, there was a statistically significant (P=0.0113) reduction in the CKD273 score from a mean of 0.161 [95% CI: -0.093 to 0.414] to -0.346 [95% CI: -0.632 to -0.060] after BAT in patients with systolic ABP decrease of ≥5mmHg. These data emphasized potential nephroprotective effects of BAT in patients with sufficient BP response.
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