Kidney Week

Abstract: FR-PO585

The Effect of Renal Denervation on Kidney Function – Does Estimating Equation Matter? The ReShape CV-Risk Study

Session Information

• Hypertension: Clinical and Translational
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Hypertension

• 1102 Hypertension: Basic and Experimental - Renal Causes and Consequences

Authors

• Solbu, Marit D., University Hospital of North Norway, Tromsø, Norway

Marit D. Solbu,

• Miroslawska, Atena, University Hospital of North Norway, Tromsø, Norway

Atena Miroslawska,

• Norvik, Jon V., University Hospital of North Norway, Tromsø, Norway

Jon V. Norvik,

• Steigen, Terje Kristian, UiT The Arctic University of Norway, Tromsø, Norway

Terje Kristian Steigen,

Background

Renal denervation (RDN) is considered as a treatment option for patients with treatment resistant hypertension (TRHT). However, the short and long term effect of RDN on kidney function has not been evaluated. Moreover, whether the various commonly used equations to estimate GFR perform equally in RDN patients has never been assessed. The aim of our study was to track changes of measured and estimated GFR (mGFR and eGFR) in patients treated with RDN for TRHT, and to compare the methods to assess GFR in this patient group.

Methods

In the ReShape CV-Risk Study, non-diabetic patients with TRHT and eGFR >45 ml/min/1.73 m² were recruited from out-patient clinics. TRHT was defined as ambulatory daytime systolic blood pressure (SBP) >135 mm Hg while treated with ≥4 antihypertensive drugs including a diuretic. Investigations,which included fasting blood tests and iohexol clearance (mGFR), were done before RDN and after 6 and 24 months. eGFR was calculated using the CKD-EPI equations for creatinine, cystatin C and the combination (eGFR_cre, eGFR_cys, eGFR_crecys).

Results

Among the 23 patients who underwent bilateral RDN in the study, 20 completed the follow-ups at 6 and 24 months and were included in this sub-study. At baseline, mean age was 54 (±9) years, mean body mass index was 32 (±5) kg/m², and 2 patients were women. Mean ambulatory SBP was 155 (±21) mm Hg at baseline, fell significantly by 9.9 (±24) mm Hg at 6 months and remained stable at 24 months. Before RDN, mGFR was 83 (±20) ml/min/1.73 m². The value was 76 (±22) ml/min/1.73 m² at 6 months (P for change from baseline =0.07), but 78 (±28) ml/min/1.73 m² at 24 months. Whereas eGFR_cre was stable from baseline to the first 6 months’ follow-up, eGFR_cys and eGFR_crecys increased significantly during the same period. However, at 24 months, mean GFR was 3.1 – 4.4 ml/min/1.73 m² lower than the baseline value regardless of method.

Conclusion

During the first months after RDN for TRHT, estimates of GFR varied with the method used, whereas measured GFR fell slightly. In this setting, eGFR may not reflect kidney function only. After longer follow-up, all estimates of GFR showed similar GFR decline as measured GFR. These findings may be considered when evaluating kidney function after RDN.

Funding

• Government Support - Non-U.S.