MP68-07 EFFECT OF EXTENSIVE ARTERY ISOLATION DURING ROBOTIC-ASSISTED PARTIAL NEPHRECTOMY ON BLOOD PRESSURE OF PATIENTS WITH POORLY CONTROLLED HYPERTENSION

Abstract

INTRODUCTION AND OBJECTIVE: To investigate whether extensive renal artery isolation during robotic-assisted partial nephrectomy (RAPN) for renal cell carcinoma (RCC) affects blood pressure (BP) of patients with poorly controlled hypertension. METHODS: We included 60 patients diagnosed with poorly controlled hypertension who underwent RAPN by an experienced surgeon. The renal artery of the treated kidney was sufficiently isolated. Systolic BP (SBP) and diastolic BP (DBP), antihypertensive medication information were obtained at baseline and 3- and 6-month follow-up after surgery. Data were collected on demographic characteristics, surgical procedures, and perioperative outcomes. Primary endpoints were changes in BP, and medications. Laboratory tests for plasma renin activity, angiotensin II, and aldosterone were assessed in patients not using renin–angiotensin blockade or antiadrenergic anti-hypertensive drugs. Predictors of SBP reduction at 3 months were assessed by multivariable logistic regression. RESULTS: All 60 RAPN procedures were successful, with no major intra- or postoperative complications. Mean SBP and DBP decreased significantly at 3 months after surgery (SBP, -7.8±6.3 mmHg, P<0.001; DBP, -4.2±6.4 mmHg, P=0.01). SBP and DBP did not differ between 3- and 6-month follow-up. The mean number of BP medications prescribed was lower at 3 months than baseline (1.7±1.0 vs 2.1±1.0, P=0.016). Among the specific 29 patients, plasma renin activity and angiotensin II and aldosterone levels were decreased. The only significant predictor of SBP reduction at 3 months was baseline SBP. CONCLUSIONS: Renal denervation with extensive renal artery isolation during RAPN may improve BP control among patients with poorly controlled hypertension in the short term.Source of Funding: None