Professional paper
Renal denervation in patients with resistant hypertension-beyond blood pressure reduction
INGRID PRKAČIN
orcid.org/0000-0002-5830-7131
; Clinical Hospital Merkur, Ivana Zajca 19, Zagreb, Croatia
IVA KLARA PRANJIĆ
; Clinical Hospital Merkur, Ivana Zajca 19, Zagreb, Croatia
DINO KASUMOVIĆ
; Clinical Hospital Merkur, Ivana Zajca 19, Zagreb, Croatia
LUKA ŠANTEK
; Clinical Hospital Merkur, Ivana Zajca 19, Zagreb, Croatia
GORDANA CAVRIĆ
; Intensive Care Unit, Merkur Clinical Hospital, Zagreb, Croatia
Abstract
Renal sympathetic denervation (RDN) has been demonstrated as an antihypertensive treatment in resistant hypertension
patients, and triggers additional positive effects on glucose metabolism and insulin sensitivity in type 2 diabetes. The clinical
implications of RDN in patients with type 2 diabetes, diabetic nephropathy and resistant hypertension have not yet been
fully defined.
We hypothesized that the small antihypertensive effects of RDN treatment will induce additional benefits on renal function
in CKD patients with type 2 diabetes and resistant hypertension.
We report the effects of RDN in two patients with type 2 diabetes, diabetic nephropathy, stage 3 chronic kidney disease
and resistant hypertension. The blood pressure (BP) reduction after RDN was an 8-9% reduction of ABPM (sustained at
consecutive follow-up visits at 3 and 6 months when compared to the baseline) and restoration of the night time dipping
pattern was associated with amelioration of albuminuria (UAR).
As proteinuria may accelerate kidney disease progression to end-stage renal failure, recognition of the antiproteinuric
treatment is essential for providing renoprotection. Therefore, randomized clinical trials are required to assess the impact
of reported changes.
Keywords
resistant hypertension; renal denervation
Hrčak ID:
134173
URI
Publication date:
1.6.2014.
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