Blood Pressure and Renal Responses to Orthostatic Stress Before and After Radiofrequency Renal Denervation in Patients with Resistant Hypertension.

TitreBlood Pressure and Renal Responses to Orthostatic Stress Before and After Radiofrequency Renal Denervation in Patients with Resistant Hypertension.
Publication TypeJournal Article
Year of Publication2018
AuthorsVuignier, Y, Grouzmann, E, Muller, O, Vakilzadeh, N, Faouzi, M, Maillard, MP, Qanadli, SD, Burnier, M, Wuerzner, G
JournalFrontiers in cardiovascular medicine
Volume5
Pagination42
Date Published05/2018
DOI10.3389/fcvm.2018.00042
ISSN2297-055X
Mots-clésGlomerular Filtration Rate, Hypertension, lower body negative pressure, renal denervation, renal plasma flow, sodium excretion, sympathetic nervous system
Abstract

Background/Aims: In patients with resistant hypertension, renal denervation (RDN) studies have mainly focused their outcomes on blood pressure (BP). The aim of this study was to evaluate the long-term effect of RDN on neurohormonal profiles, renal hemodynamics and sodium excretion in a resting state and during stress induced by lower body negative pressure (LBNP).

Materials and methods: This was a single center prospective observational study. Norepinephrine, plasma renin activity (PRA), glomerular filtration rate (GFR), renal plasma flow (RPF) and sodium excretion were measured in unstimulated conditions (rest) and after one hour of LBNP at three different time points: before (M0), one (M1) and twelve months (M12) after RDN.

Results: Thirteen patients with resistant hypertension were included. In the resting state, no differences were observed in norepinephrine, PRA, sodium excretion and mean BP levels after RDN. GFR (78 ± 32 ml/min at M0 vs 66 ± 26 ml/min at M12 ( = 0.012) and filtration fraction (22.6 ±5.4% at M0 vs 15.1 ±5.3% at M12 ( = 0.002)) both decreased after RDN. During LBNP, the magnitude of the mean BP increase was reduced from +6.8 ± 6.6 mm Hg at M0 to +2.3 ± 1.3 mm Hg at M12 ( = 0.005). The LBNP-induced increase in norepinephrine and decrease in GFR and sodium excretion observed before RDN were blunted after the procedure.

Conclusion: A decrease in GFR and filtration fraction was observed one year after RDN. In addition, our results suggest that RDN blunts not only the norepinephrine but also the mean BP, the GFR and the sodium excretion responses to an orthostatic stress one year after the intervention.

Registry number: NCT01734096.

Alternate URL

http://www.ncbi.nlm.nih.gov/pubmed/29876358?dopt=Abstract

Alternate JournalFront Cardiovasc Med
Citation Key / SERVAL ID8954
Peer reviewRefereed
PubMed ID29876358
PubMed Central IDPMC5975430
                         

IUMSP | www.iumsp.ch
Institut universitaire de médecine sociale et préventive
Route de la Corniche 10, 1010 Lausanne - Switzerland
+41 21 314 72 72 | iumsp@chuv.ch

Go to top