Renal excretory function in patients with resistant arterial hypertension after radiofrequency kidney denervation at three-year follow-up

Abstract

It is generally accepted that the true-resistant hypertension (RH) currently remains critical issue. At present there is some published evidence that catheter renal denervation prosedure showed effectiveness at randomized clinical trials. The assessment of renal function after the technique is crucial.THE AIM of the study was to estimate renal function after renal artery denervation procedure in patients with uncontrolled hypertension in 3 – years follow-up.PATIENTS AND METHODS. The diagnosis of RH was made in the absence of any evidence of secondary hypertension. 40 patients (20 male and и 20 female), aged 55,5± 7,2 years, with office systolic blood pressure (BP) 180 ±26,1 mm Hg, and diastolic BP 107,4±13,9 mm Hg were examined. Glomerular filtration rate (GFR, MDRD) and microalbuminuria level was determined by averaging all measurements performed during hospitalization. Ambulatory blood pressure monitoring (BPM) was performed in all patients.RESULTS. BPM has revealed the significant decrease of systolic daytime blood pressure (at baseline 161,1±16,9 mm Hg and at follow-up 155,4±20,8 mm Hg; р= 0,024) and decrease of diastolic daytime BP (at baseline 95,6 ±11,8 mmHg and at follow -up 90,2 ±12,4 mm Hg; р=0,002). During 3 -year of follow-up the serum creatinine level has increased at baseline 69,5±16,4 μmol/l and at follow-up 78,7±19,5 μmol/l; р<0,0001). The Glomerular filtration rate has scaled down (at baseline 98,2±18,7 ml/min and at follow-up 85,1±17,9 ml/min; р< 0,0001). The level of daily excretion of albumin has also decreased (at baseline 30,4 [14,6; 52,9] mg and at follow-up 14,1 [11,9; 42,4] mg correspondingly; р= 0,03) .CONCLUSION. Although BP profile changes have demonstrated the effectiveness of RDN, therefore the future investigation of exact patho-physiological significance of glomerular filtration level after the treatment of RH should be of provided.