Abstract: FR-PO583

The Impact on Central Blood Pressure and Arterial Stiffness Post-Renal Denervation (RDN) in Patients with Stage 3 and 4 CKD: The Prairie RDN Study

Session Information

Category: Hypertension

  • 1104 Hypertension: Clinical and Translational - Salt and Hypertension

Authors

  • Prasad, Bhanu, None, Regina, Saskatchewan, Canada
  • Giebel, Shelley, Regina QuAppelle Health Region, Regina, Saskatchewan, Canada
  • McCarron, Michelle C. E., Regina Qu''Appelle Health Region, Regina, Saskatchewan, Canada
Background

It is now recognized that central blood pressures (CBP) and arterial stiffness are better indicators of cardiovascular outcomes than brachial blood pressures (BBP's). Renal denervation (RDN) procedure has been shown to improve blood pressures by interrupting the afferent and efferent sympathetic nerves that traverse through the adventitia of the renal arteries. While there is evidence of improvement in BBP's in patients with stages 3 and 4 CKD, the impact of RDN on CBP's has not yet been examined.

Methods

We conducted a single-center, prospective study with pre and post-RDN follow-up. 26 patients with Stage 3 or Stage 4 CKD and resistant hypertension, with no radiological or laboratory evidence of secondary causes of hypertension underwent RDN between Jan 2014 to July 2015 at the Regina General Hospital, Canada. CBP's were measured by radial tonometry (Sphygmocor), ambulatory 24-hour blood pressure (Welch Allyn), office blood pressures (BP Tru) and pulse wave velocity (PWV) by Sphygmocor. Our primary outcome was to identify an improvement in CBP at 6 months post procedure. Secondary outcomes were to identify improvement in peripheral pressures, central pressures, pulse wave velocity at baseline, 6 and 24 months.

Results

'There was a significant improvement in brachial blood pressures (median, mm Hg) (147.5/77 ) at baseline, (135/75) at 6 months and (133/74.5) at 24 months (p=<0.001). Mean central blood pressures (mm Hg) were (126/77) at baseline, (118/75) at 6 months and (118/67) at 24 months (p=0.18). Mean ambulatory 12-hour day (mm Hg) was (147/67) at baseline, (144/67) at 6 months and (150/69) at 24 months (p=0.27). Mean ambulatory 12-hour night BP (mm Hg) was (142/65) at baseline, (141/63) at 6 months and (143/65) at 24 months (p=0.93). Mean PWV (in m/s) was (13.8) at baseline, (13.3) at 6 months and (15.6) at 24 months time.

Conclusion

Our study demonstrates that there was a significant improvement in peripheral blood pressures from baseline to 6 months and was maintained at 24 months. There was a downward trend in central blood pressures although it did not reach statistical significance. There was no change in ambulatory blood pressures and PWV. It’s the first study that looks at central blood pressures post RDN in CKD patients to our knowledge.