Changes in albumin-to-creatinine ratio at 12-month follow-up in patients undergoing renal denervation

Henrique Sousa, Patrícia Branco, Manuel de Sousa Almeida, Pedro de Araújo Gonçalves, Augusta Gaspar, Hélder Dores, João Rodrigo Mesquita, Maria João Andrade, Nuno Neuparth, Ana Aleixo, Miguel Mendes, José Diogo Barata

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Abstract

Introduction: Sympathetic renal denervation (RDN) was developed as a treatment for the management of patients with resistant hypertension. This procedure may have a positive impact on hypertension-related target organ damage, particularly renal disease, but the evidence is still limited. Objective: To assess the impact of RDN on the albumin-to-creatinine ratio (ACR) at 12-month follow-up. Methods and Results: From a single-center prospective registry including 65 patients with resistant hypertension undergoing renal denervation, 31 patients with complete baseline and 12-month follow-up blood pressure (BP) measurements (both office and 24-h ambulatory blood pressure monitoring [ABPM]) and ACR were included in the present study. Mean age was 65±7 years, 52% were female, most (90%) had been diagnosed with hypertension for more than 10 years, 71% had type 2 diabetes and 33% had vascular disease in at least one territory. Mean estimated glomerular filtration rate was 73.6±25.1 ml/min/1.73 m2 and 15 patients (48%) had an ACR >30 mg/g. After 12 months, 22 patients were considered BP responders (73%). ACR decreased significantly from a median of 25.8 mg/g (interquartile range [IQR] 9.0-574.0 mg/g) to 14.8 mg/g (IQR 4.5-61.0 mg/g, p=0.007). When the results were split according to systolic BP responder status on ABPM, we found a significant reduction in responders (from 25.6 mg/g [IQR 8.7-382.8 mg/g] to 15.9 mg/g [IQR 4.4-55.0 mg/g], p=0.009), and a numerical decrease in the non-responder subgroup (from 165.0 mg/g [IQR 8.8-1423.5 mg/g] to 13.6 mg/dl [IQR 5.7-1417.0 mg/g], p=0.345). Conclusions: Besides significant reductions in blood pressure (both office and 24-h ABPM), renal denervation was associated with a significant reduction in ACR, a recognized marker of target organ damage.

Original languageEnglish
Pages (from-to)343-351
Number of pages8
JournalRevista Portuguesa de Cardiologia
Volume36
Issue number5
Early online date26 Apr 2017
DOIs
Publication statusPublished - May 2017

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Denervation
Albumins
Creatinine
Ambulatory Blood Pressure Monitoring
Blood Pressure
Kidney
Hypertension
Renal Hypertension
Sympathectomy
Glomerular Filtration Rate
Vascular Diseases
Type 2 Diabetes Mellitus
Registries

Keywords

  • Albuminuria
  • Blood pressure
  • Renal denervation
  • Resistant hypertension

Cite this

@article{3a1562696fee46fbb1546918098dd82b,
title = "Changes in albumin-to-creatinine ratio at 12-month follow-up in patients undergoing renal denervation",
abstract = "Introduction: Sympathetic renal denervation (RDN) was developed as a treatment for the management of patients with resistant hypertension. This procedure may have a positive impact on hypertension-related target organ damage, particularly renal disease, but the evidence is still limited. Objective: To assess the impact of RDN on the albumin-to-creatinine ratio (ACR) at 12-month follow-up. Methods and Results: From a single-center prospective registry including 65 patients with resistant hypertension undergoing renal denervation, 31 patients with complete baseline and 12-month follow-up blood pressure (BP) measurements (both office and 24-h ambulatory blood pressure monitoring [ABPM]) and ACR were included in the present study. Mean age was 65±7 years, 52{\%} were female, most (90{\%}) had been diagnosed with hypertension for more than 10 years, 71{\%} had type 2 diabetes and 33{\%} had vascular disease in at least one territory. Mean estimated glomerular filtration rate was 73.6±25.1 ml/min/1.73 m2 and 15 patients (48{\%}) had an ACR >30 mg/g. After 12 months, 22 patients were considered BP responders (73{\%}). ACR decreased significantly from a median of 25.8 mg/g (interquartile range [IQR] 9.0-574.0 mg/g) to 14.8 mg/g (IQR 4.5-61.0 mg/g, p=0.007). When the results were split according to systolic BP responder status on ABPM, we found a significant reduction in responders (from 25.6 mg/g [IQR 8.7-382.8 mg/g] to 15.9 mg/g [IQR 4.4-55.0 mg/g], p=0.009), and a numerical decrease in the non-responder subgroup (from 165.0 mg/g [IQR 8.8-1423.5 mg/g] to 13.6 mg/dl [IQR 5.7-1417.0 mg/g], p=0.345). Conclusions: Besides significant reductions in blood pressure (both office and 24-h ABPM), renal denervation was associated with a significant reduction in ACR, a recognized marker of target organ damage.",
keywords = "Albuminuria, Blood pressure, Renal denervation, Resistant hypertension",
author = "Henrique Sousa and Patr{\'i}cia Branco and {de Sousa Almeida}, Manuel and {de Ara{\'u}jo Gon{\cc}alves}, Pedro and Augusta Gaspar and H{\'e}lder Dores and Mesquita, {Jo{\~a}o Rodrigo} and Andrade, {Maria Jo{\~a}o} and Nuno Neuparth and Ana Aleixo and Miguel Mendes and Barata, {Jos{\'e} Diogo}",
year = "2017",
month = "5",
doi = "10.1016/j.repc.2016.09.019",
language = "English",
volume = "36",
pages = "343--351",
journal = "Revista Portuguesa de Cardiologia",
issn = "0870-2551",
publisher = "Sociedade Portuguesa de Cardiologia",
number = "5",

}

TY - JOUR

T1 - Changes in albumin-to-creatinine ratio at 12-month follow-up in patients undergoing renal denervation

AU - Sousa, Henrique

AU - Branco, Patrícia

AU - de Sousa Almeida, Manuel

AU - de Araújo Gonçalves, Pedro

AU - Gaspar, Augusta

AU - Dores, Hélder

AU - Mesquita, João Rodrigo

AU - Andrade, Maria João

AU - Neuparth, Nuno

AU - Aleixo, Ana

AU - Mendes, Miguel

AU - Barata, José Diogo

PY - 2017/5

Y1 - 2017/5

N2 - Introduction: Sympathetic renal denervation (RDN) was developed as a treatment for the management of patients with resistant hypertension. This procedure may have a positive impact on hypertension-related target organ damage, particularly renal disease, but the evidence is still limited. Objective: To assess the impact of RDN on the albumin-to-creatinine ratio (ACR) at 12-month follow-up. Methods and Results: From a single-center prospective registry including 65 patients with resistant hypertension undergoing renal denervation, 31 patients with complete baseline and 12-month follow-up blood pressure (BP) measurements (both office and 24-h ambulatory blood pressure monitoring [ABPM]) and ACR were included in the present study. Mean age was 65±7 years, 52% were female, most (90%) had been diagnosed with hypertension for more than 10 years, 71% had type 2 diabetes and 33% had vascular disease in at least one territory. Mean estimated glomerular filtration rate was 73.6±25.1 ml/min/1.73 m2 and 15 patients (48%) had an ACR >30 mg/g. After 12 months, 22 patients were considered BP responders (73%). ACR decreased significantly from a median of 25.8 mg/g (interquartile range [IQR] 9.0-574.0 mg/g) to 14.8 mg/g (IQR 4.5-61.0 mg/g, p=0.007). When the results were split according to systolic BP responder status on ABPM, we found a significant reduction in responders (from 25.6 mg/g [IQR 8.7-382.8 mg/g] to 15.9 mg/g [IQR 4.4-55.0 mg/g], p=0.009), and a numerical decrease in the non-responder subgroup (from 165.0 mg/g [IQR 8.8-1423.5 mg/g] to 13.6 mg/dl [IQR 5.7-1417.0 mg/g], p=0.345). Conclusions: Besides significant reductions in blood pressure (both office and 24-h ABPM), renal denervation was associated with a significant reduction in ACR, a recognized marker of target organ damage.

AB - Introduction: Sympathetic renal denervation (RDN) was developed as a treatment for the management of patients with resistant hypertension. This procedure may have a positive impact on hypertension-related target organ damage, particularly renal disease, but the evidence is still limited. Objective: To assess the impact of RDN on the albumin-to-creatinine ratio (ACR) at 12-month follow-up. Methods and Results: From a single-center prospective registry including 65 patients with resistant hypertension undergoing renal denervation, 31 patients with complete baseline and 12-month follow-up blood pressure (BP) measurements (both office and 24-h ambulatory blood pressure monitoring [ABPM]) and ACR were included in the present study. Mean age was 65±7 years, 52% were female, most (90%) had been diagnosed with hypertension for more than 10 years, 71% had type 2 diabetes and 33% had vascular disease in at least one territory. Mean estimated glomerular filtration rate was 73.6±25.1 ml/min/1.73 m2 and 15 patients (48%) had an ACR >30 mg/g. After 12 months, 22 patients were considered BP responders (73%). ACR decreased significantly from a median of 25.8 mg/g (interquartile range [IQR] 9.0-574.0 mg/g) to 14.8 mg/g (IQR 4.5-61.0 mg/g, p=0.007). When the results were split according to systolic BP responder status on ABPM, we found a significant reduction in responders (from 25.6 mg/g [IQR 8.7-382.8 mg/g] to 15.9 mg/g [IQR 4.4-55.0 mg/g], p=0.009), and a numerical decrease in the non-responder subgroup (from 165.0 mg/g [IQR 8.8-1423.5 mg/g] to 13.6 mg/dl [IQR 5.7-1417.0 mg/g], p=0.345). Conclusions: Besides significant reductions in blood pressure (both office and 24-h ABPM), renal denervation was associated with a significant reduction in ACR, a recognized marker of target organ damage.

KW - Albuminuria

KW - Blood pressure

KW - Renal denervation

KW - Resistant hypertension

UR - http://www.scopus.com/inward/record.url?scp=85018706617&partnerID=8YFLogxK

U2 - 10.1016/j.repc.2016.09.019

DO - 10.1016/j.repc.2016.09.019

M3 - Article

VL - 36

SP - 343

EP - 351

JO - Revista Portuguesa de Cardiologia

JF - Revista Portuguesa de Cardiologia

SN - 0870-2551

IS - 5

ER -