IMPACT OF RENAL SYMPATHETIC DENERVATION ON RENAL FUNCTIONAL RESERVE IN HYPERTENSIVE PATIENTS - STUDY DESIGN AND PRELIMINARY DATA

Objective: To search the impact of catheter-based renal sympathetic denervation (RDN) on renal functional reserve (RFR) in patients with essential hypertension with normal renal function or chronic renal disease with an estimated glomerular filtration rate (eGFR)>=30 ml/min/1.73m2. Design and method: Patients with essential, uncontrolled hypertension either under antihypertensive treatment with one drug class or naive from antihypertensive treatment, with normal renal function or chronic kidney disease (CKD) up to stage IIIb (eGFR >=30 ml/min/1.73m2) are eligible for enrollment. RFR is estimated before and three months after RDN. In addition, the urine albumin/creatinine ratio (UACR) and 24-hour urine protein after 24-hour home urine collection are measured at the same time points.Results: Twelve patients were enrolled and completed follow-up three months after RDN. Three patients had stage 2 CKD. 25% of patients had microalbuminuria. At baseline, RFR in 75% of patients was below the normal value. eGFR did not change significantly after RDN (p=0.19). There was a trend towards decrease in UACR and 24-hour urine protein (p=0.17) and a trend towards increase in RFR value three months post-RDN (p=0.11). Table 1 - baseline characteristics Age (mean, years): 54 Male sex (n, %): 11 (92%) Chronic kidney disease (n, %) Stage 1: 9 (75%) Stage 2: 3 (25%) Table 2 - clinical data ABPM (mean, mmHg): 154/107 eGFR (ml/min/1.73m2): 98 24-hour urine protein (range, mg/24 h) (pre-RDN): 56-204 (post-RDN): 51-184.8 RFR (range, ml/min/1.73m2) (pre-RDN): 14.2-39.7 (post-RDN): 15.7-62.8 Conclusions: In this initial part of our protocol, there was a trend towards decrease in UACR and 24-hour urine protein and a numerical trend towards increase in RFR value three months post-RDN. Four patients with stage 3 CKD were also enrolled in our study, however, follow-up is pending. Patients are still enrolled and data on larger pool are anticipated.