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Article

Relevance of Targeting the Distal Renal Artery and Branches with Radiofrequency Renal Denervation Approaches—A Secondary Analysis from a Hypertensive CKD Patient Cohort

by
Márcio Galindo Kiuchi
1,*,
Markus P. Schlaich
1,2,3,
Shaojie Chen
4,
Humberto Villacorta
5,
Jan K. Ho
1,
Revathy Carnagarin
1,
Vance B. Matthews
1 and
Jocemir Ronaldo Lugon
6
1
Dobney Hypertension Cenre, School of Medicine—Royal Perth Hospital Unit, Faculty of Medicine, Dentistry & Health Sciences, The University of Western Australia Level 3, MRF Building, Rear 50 Murray St, Perth WA 6000, MDBP: M570, Australia
2
Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth WA 6000, Australia
3
Neurovascular Hypertension & Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne VIC 3004, Australia
4
Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Frankfurt am Main 60431, Germany
5
Cardiology Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ 24033-900, Brazil
6
Nephrology Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ 24033-900, Brazil
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(5), 581; https://doi.org/10.3390/jcm8050581
Submission received: 21 March 2019 / Revised: 24 April 2019 / Accepted: 25 April 2019 / Published: 27 April 2019
(This article belongs to the Special Issue Autonomic Nervous System: From Bench to Bedside)
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Abstract

We searched for an association between changes in blood pressure (BP) at 12 and 24 months after renal denervation (RDN) and the different patterns of ablation spots placement along the renal artery vasculature. We performed a post-hoc analysis of a 24-month follow-up evaluation of 30 patients who underwent RDN between 2011 and 2012 using our previous database. Patients who had (i) resistant hypertension, as meticulously described previously, and (ii) Chronic kidney disease (CKD) stages 2, 3 and 4. Correlations were assessed using the Pearson or Spearman correlation tests as appropriate. The mean change in systolic ambulatory BP monitoring (ABPM) compared to baseline was −19.4 ± 12.7 mmHg at the 12th (p < 0.0001) and −21.3 ± 14.1 mmHg at the 24th month (p < 0.0001). There was no correlation between the ABPM Systolic Blood Pressure (SBP)-lowering effect and the total number of ablated spots in renal arteries (17.7 ± 6.0) either at 12 (r = −0.3, p = 0.1542) or at 24 months (r = −0.2, p = 0.4009). However, correlations between systolic BP-lowering effect and the number of ablation spots performed in the distal segment and branches were significant at the 12 (r = −0.7, p < 0.0001) and 24 months (r = −0.8, p < 0.0001) follow-up. Our findings indicate a substantial correlation between the numbers of ablated sites in the distal segment and branches of renal arteries and the systolic BP-lowering effect in the long-term.
Keywords: hypertension; chronic kidney disease; renal denervation; blood pressure reduction; sympathetic nervous system hypertension; chronic kidney disease; renal denervation; blood pressure reduction; sympathetic nervous system

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MDPI and ACS Style

Kiuchi, M.G.; Schlaich, M.P.; Chen, S.; Villacorta, H.; Ho, J.K.; Carnagarin, R.; Matthews, V.B.; Lugon, J.R. Relevance of Targeting the Distal Renal Artery and Branches with Radiofrequency Renal Denervation Approaches—A Secondary Analysis from a Hypertensive CKD Patient Cohort. J. Clin. Med. 2019, 8, 581. https://doi.org/10.3390/jcm8050581

AMA Style

Kiuchi MG, Schlaich MP, Chen S, Villacorta H, Ho JK, Carnagarin R, Matthews VB, Lugon JR. Relevance of Targeting the Distal Renal Artery and Branches with Radiofrequency Renal Denervation Approaches—A Secondary Analysis from a Hypertensive CKD Patient Cohort. Journal of Clinical Medicine. 2019; 8(5):581. https://doi.org/10.3390/jcm8050581

Chicago/Turabian Style

Kiuchi, Márcio Galindo, Markus P. Schlaich, Shaojie Chen, Humberto Villacorta, Jan K. Ho, Revathy Carnagarin, Vance B. Matthews, and Jocemir Ronaldo Lugon. 2019. "Relevance of Targeting the Distal Renal Artery and Branches with Radiofrequency Renal Denervation Approaches—A Secondary Analysis from a Hypertensive CKD Patient Cohort" Journal of Clinical Medicine 8, no. 5: 581. https://doi.org/10.3390/jcm8050581

APA Style

Kiuchi, M. G., Schlaich, M. P., Chen, S., Villacorta, H., Ho, J. K., Carnagarin, R., Matthews, V. B., & Lugon, J. R. (2019). Relevance of Targeting the Distal Renal Artery and Branches with Radiofrequency Renal Denervation Approaches—A Secondary Analysis from a Hypertensive CKD Patient Cohort. Journal of Clinical Medicine, 8(5), 581. https://doi.org/10.3390/jcm8050581

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