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Renal Hemodynamics and Renal Function After Catheter-Based Renal Sympathetic Denervation in Patients With Resistant Hypertension

Increased renal resistive index and urinary albumin excretion are markers of hypertensive end-organ damage and renal vasoconstriction involving increased sympathetic activity. Catheter-based sympathetic renal denervation (RD) offers a new approach to reduce renal sympathetic activity and blood press... Full description

Journal Title: Hypertension (Dallas Tex. 1979), 2012-08, Vol.60 (2), p.419-424
Main Author: Mahfoud, Felix
Other Authors: Cremers, Bodo , Janker, Julia , Link, Britta , Vonend, Oliver , Ukena, Christian , Linz, Dominik , Schmieder, Roland , Rump, Lars Christian , Kindermann, Ingrid , Sobotka, Paul Andrew , Krum, Henry , Scheller, Bruno , Schlaich, Markus , Laufs, Ulrich , Böhm, Michael
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Hagerstown, MD: American Heart Association, Inc
ID: ISSN: 0194-911X
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recordid: cdi_proquest_miscellaneous_1027370685
title: Renal Hemodynamics and Renal Function After Catheter-Based Renal Sympathetic Denervation in Patients With Resistant Hypertension
format: Article
creator:
  • Mahfoud, Felix
  • Cremers, Bodo
  • Janker, Julia
  • Link, Britta
  • Vonend, Oliver
  • Ukena, Christian
  • Linz, Dominik
  • Schmieder, Roland
  • Rump, Lars Christian
  • Kindermann, Ingrid
  • Sobotka, Paul Andrew
  • Krum, Henry
  • Scheller, Bruno
  • Schlaich, Markus
  • Laufs, Ulrich
  • Böhm, Michael
subjects:
  • Albuminuria - epidemiology
  • Arterial hypertension. Arterial hypotension
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • Blood Pressure - physiology
  • Cardiology. Vascular system
  • Catheters
  • Cystatin C - urine
  • Drug Resistance
  • Female
  • Follow-Up Studies
  • Fundamental and applied biological sciences. Psychology
  • Glomerular Filtration Rate - physiology
  • Hemodynamics - physiology
  • Humans
  • Hypertension - drug therapy
  • Hypertension - physiopathology
  • Hypertension - therapy
  • Incidence
  • Kidney - blood supply
  • Kidney - innervation
  • Kidney - physiology
  • Kidney Function Tests
  • Male
  • Medical sciences
  • Middle Aged
  • Sympathectomy - instrumentation
  • Sympathectomy - methods
  • Treatment Outcome
  • Vertebrates: urinary system
ispartof: Hypertension (Dallas, Tex. 1979), 2012-08, Vol.60 (2), p.419-424
description: Increased renal resistive index and urinary albumin excretion are markers of hypertensive end-organ damage and renal vasoconstriction involving increased sympathetic activity. Catheter-based sympathetic renal denervation (RD) offers a new approach to reduce renal sympathetic activity and blood pressure in resistant hypertension. The influence of RD on renal hemodynamics, renal function, and urinary albumin excretion has not been studied. One hundred consecutive patients with resistant hypertension were included in the study; 88 underwent interventional RD and 12 served as controls. Systolic, diastolic, and pulse pressure, as well renal resistive index in interlobar arteries, renal function, and urinary albumin excretion, were measured before and at 3 and 6 months of follow-up. RD reduced systolic, diastolic, and pulse pressure at 3 and 6 months by 22.7/26.6 mm Hg, 7.7/9.7 mm Hg, and 15.1/17.5 mm Hg (P for all
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
url: Link


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titleRenal Hemodynamics and Renal Function After Catheter-Based Renal Sympathetic Denervation in Patients With Resistant Hypertension
creatorMahfoud, Felix ; Cremers, Bodo ; Janker, Julia ; Link, Britta ; Vonend, Oliver ; Ukena, Christian ; Linz, Dominik ; Schmieder, Roland ; Rump, Lars Christian ; Kindermann, Ingrid ; Sobotka, Paul Andrew ; Krum, Henry ; Scheller, Bruno ; Schlaich, Markus ; Laufs, Ulrich ; Böhm, Michael
creatorcontribMahfoud, Felix ; Cremers, Bodo ; Janker, Julia ; Link, Britta ; Vonend, Oliver ; Ukena, Christian ; Linz, Dominik ; Schmieder, Roland ; Rump, Lars Christian ; Kindermann, Ingrid ; Sobotka, Paul Andrew ; Krum, Henry ; Scheller, Bruno ; Schlaich, Markus ; Laufs, Ulrich ; Böhm, Michael
descriptionIncreased renal resistive index and urinary albumin excretion are markers of hypertensive end-organ damage and renal vasoconstriction involving increased sympathetic activity. Catheter-based sympathetic renal denervation (RD) offers a new approach to reduce renal sympathetic activity and blood pressure in resistant hypertension. The influence of RD on renal hemodynamics, renal function, and urinary albumin excretion has not been studied. One hundred consecutive patients with resistant hypertension were included in the study; 88 underwent interventional RD and 12 served as controls. Systolic, diastolic, and pulse pressure, as well renal resistive index in interlobar arteries, renal function, and urinary albumin excretion, were measured before and at 3 and 6 months of follow-up. RD reduced systolic, diastolic, and pulse pressure at 3 and 6 months by 22.7/26.6 mm Hg, 7.7/9.7 mm Hg, and 15.1/17.5 mm Hg (P for all <0.001), respectively, without significant changes in the control group. SBP reduction after 6 months correlated with SBP baseline values (r=−0.46; P<0.001). There were no renal artery stenoses, dissections, or aneurysms during 6 months of follow-up. Renal resistive index decreased from 0.691±0.01 at baseline to 0.674±0.01 and 0.670±0.01 (P=0.037/0.017) at 3- and 6-month follow-up. Mean cystatin C glomerular filtration rate and urinary albumin excretion remained unchanged after RD; however, the number of patients with microalbuminuria or macroalbuminuria decreased. RD reduced blood pressure, renal resistive index, and incidence of albuminuria without adversely affecting glomerular filtration rate or renal artery structure within 6 months and appears to be a safe and effective therapeutic approach to lower blood pressure in patients with resistant hypertension.
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languageeng
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subjectAlbuminuria - epidemiology ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Pressure - physiology ; Cardiology. Vascular system ; Catheters ; Cystatin C - urine ; Drug Resistance ; Female ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Glomerular Filtration Rate - physiology ; Hemodynamics - physiology ; Humans ; Hypertension - drug therapy ; Hypertension - physiopathology ; Hypertension - therapy ; Incidence ; Kidney - blood supply ; Kidney - innervation ; Kidney - physiology ; Kidney Function Tests ; Male ; Medical sciences ; Middle Aged ; Sympathectomy - instrumentation ; Sympathectomy - methods ; Treatment Outcome ; Vertebrates: urinary system
ispartofHypertension (Dallas, Tex. 1979), 2012-08, Vol.60 (2), p.419-424
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0Mahfoud, Felix
1Cremers, Bodo
2Janker, Julia
3Link, Britta
4Vonend, Oliver
5Ukena, Christian
6Linz, Dominik
7Schmieder, Roland
8Rump, Lars Christian
9Kindermann, Ingrid
10Sobotka, Paul Andrew
11Krum, Henry
12Scheller, Bruno
13Schlaich, Markus
14Laufs, Ulrich
15Böhm, Michael
title
0Renal Hemodynamics and Renal Function After Catheter-Based Renal Sympathetic Denervation in Patients With Resistant Hypertension
1Hypertension (Dallas, Tex. 1979)
addtitleHypertension
descriptionIncreased renal resistive index and urinary albumin excretion are markers of hypertensive end-organ damage and renal vasoconstriction involving increased sympathetic activity. Catheter-based sympathetic renal denervation (RD) offers a new approach to reduce renal sympathetic activity and blood pressure in resistant hypertension. The influence of RD on renal hemodynamics, renal function, and urinary albumin excretion has not been studied. One hundred consecutive patients with resistant hypertension were included in the study; 88 underwent interventional RD and 12 served as controls. Systolic, diastolic, and pulse pressure, as well renal resistive index in interlobar arteries, renal function, and urinary albumin excretion, were measured before and at 3 and 6 months of follow-up. RD reduced systolic, diastolic, and pulse pressure at 3 and 6 months by 22.7/26.6 mm Hg, 7.7/9.7 mm Hg, and 15.1/17.5 mm Hg (P for all <0.001), respectively, without significant changes in the control group. SBP reduction after 6 months correlated with SBP baseline values (r=−0.46; P<0.001). There were no renal artery stenoses, dissections, or aneurysms during 6 months of follow-up. Renal resistive index decreased from 0.691±0.01 at baseline to 0.674±0.01 and 0.670±0.01 (P=0.037/0.017) at 3- and 6-month follow-up. Mean cystatin C glomerular filtration rate and urinary albumin excretion remained unchanged after RD; however, the number of patients with microalbuminuria or macroalbuminuria decreased. RD reduced blood pressure, renal resistive index, and incidence of albuminuria without adversely affecting glomerular filtration rate or renal artery structure within 6 months and appears to be a safe and effective therapeutic approach to lower blood pressure in patients with resistant hypertension.
subject
0Albuminuria - epidemiology
1Arterial hypertension. Arterial hypotension
2Biological and medical sciences
3Blood and lymphatic vessels
4Blood Pressure - physiology
5Cardiology. Vascular system
6Catheters
7Cystatin C - urine
8Drug Resistance
9Female
10Follow-Up Studies
11Fundamental and applied biological sciences. Psychology
12Glomerular Filtration Rate - physiology
13Hemodynamics - physiology
14Humans
15Hypertension - drug therapy
16Hypertension - physiopathology
17Hypertension - therapy
18Incidence
19Kidney - blood supply
20Kidney - innervation
21Kidney - physiology
22Kidney Function Tests
23Male
24Medical sciences
25Middle Aged
26Sympathectomy - instrumentation
27Sympathectomy - methods
28Treatment Outcome
29Vertebrates: urinary system
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8Rump, Lars Christian
9Kindermann, Ingrid
10Sobotka, Paul Andrew
11Krum, Henry
12Scheller, Bruno
13Schlaich, Markus
14Laufs, Ulrich
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titleRenal Hemodynamics and Renal Function After Catheter-Based Renal Sympathetic Denervation in Patients With Resistant Hypertension
authorMahfoud, Felix ; Cremers, Bodo ; Janker, Julia ; Link, Britta ; Vonend, Oliver ; Ukena, Christian ; Linz, Dominik ; Schmieder, Roland ; Rump, Lars Christian ; Kindermann, Ingrid ; Sobotka, Paul Andrew ; Krum, Henry ; Scheller, Bruno ; Schlaich, Markus ; Laufs, Ulrich ; Böhm, Michael
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1Arterial hypertension. Arterial hypotension
2Biological and medical sciences
3Blood and lymphatic vessels
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7Cystatin C - urine
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9Female
10Follow-Up Studies
11Fundamental and applied biological sciences. Psychology
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15Hypertension - drug therapy
16Hypertension - physiopathology
17Hypertension - therapy
18Incidence
19Kidney - blood supply
20Kidney - innervation
21Kidney - physiology
22Kidney Function Tests
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24Medical sciences
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27Sympathectomy - methods
28Treatment Outcome
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5Ukena, Christian
6Linz, Dominik
7Schmieder, Roland
8Rump, Lars Christian
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10Sobotka, Paul Andrew
11Krum, Henry
12Scheller, Bruno
13Schlaich, Markus
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8Rump, Lars Christian
9Kindermann, Ingrid
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13Schlaich, Markus
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abstractIncreased renal resistive index and urinary albumin excretion are markers of hypertensive end-organ damage and renal vasoconstriction involving increased sympathetic activity. Catheter-based sympathetic renal denervation (RD) offers a new approach to reduce renal sympathetic activity and blood pressure in resistant hypertension. The influence of RD on renal hemodynamics, renal function, and urinary albumin excretion has not been studied. One hundred consecutive patients with resistant hypertension were included in the study; 88 underwent interventional RD and 12 served as controls. Systolic, diastolic, and pulse pressure, as well renal resistive index in interlobar arteries, renal function, and urinary albumin excretion, were measured before and at 3 and 6 months of follow-up. RD reduced systolic, diastolic, and pulse pressure at 3 and 6 months by 22.7/26.6 mm Hg, 7.7/9.7 mm Hg, and 15.1/17.5 mm Hg (P for all <0.001), respectively, without significant changes in the control group. SBP reduction after 6 months correlated with SBP baseline values (r=−0.46; P<0.001). There were no renal artery stenoses, dissections, or aneurysms during 6 months of follow-up. Renal resistive index decreased from 0.691±0.01 at baseline to 0.674±0.01 and 0.670±0.01 (P=0.037/0.017) at 3- and 6-month follow-up. Mean cystatin C glomerular filtration rate and urinary albumin excretion remained unchanged after RD; however, the number of patients with microalbuminuria or macroalbuminuria decreased. RD reduced blood pressure, renal resistive index, and incidence of albuminuria without adversely affecting glomerular filtration rate or renal artery structure within 6 months and appears to be a safe and effective therapeutic approach to lower blood pressure in patients with resistant hypertension.
copHagerstown, MD
pubAmerican Heart Association, Inc
pmid22733462
doi10.1161/HYPERTENSIONAHA.112.193870
oafree_for_read