Kidney Week

Abstract: FR-PO0584

Albuminuria and Cardiorenal Outcomes After Radiofrequency Renal Denervation in Patients with Hypertension

Session Information

• CKM: Clinical - Meta-Analyses, Predictive Modeling, Care Delivery, and Safety
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Townsend, Raymond R., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Raymond R. Townsend, MD

• Schlaich, Markus P., Dobney Hypertension Centre, Medical School, Royal Perth Hospital Unit and RPHO Medical Research Foundation, Perth, Western Australia, Australia

Markus P. Schlaich, MD

• Böhm, Michael, HOMICAREM (HOMburg Institute for CArdioREnalMetabolic Medicine), Saarland University, Saarland, Germany

Michael Böhm, MD

• Mahfoud, Felix, Department of Cardiology, University of Heart Center, University Hospital Basel, Basel, Switzerland

Felix Mahfoud, MD

• Ribichini, Flavio Luciano, Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy

Flavio Luciano Ribichini, MD

• Weber, Thomas, Cardiology Department, Klinikum Wels-Grieskirchen, Wels, Austria

Thomas Weber, MD

• Kelle, Sebastian, Deutsches Herzzentrum der Charité, Berlin, Germany

Sebastian Kelle, MD

• Gonçalves, Pedro, Comprehensive Health Research Center (CHRC), LA-REAL, NOVA Medical School, Lisbon, Portugal

Pedro Gonçalves, MD

• Kim, Maria, Medtronic Inc, Minneapolis, Minnesota, United States

Maria Kim, MBChB, PhD

• Maus, Baerbel, Medtronic Inc, Minneapolis, Minnesota, United States

Baerbel Maus, MSc, PhD

• Schmieder, Roland E., University Hospital Erlangen, Erlangen, Germany

Roland E. Schmieder, MD, FASN

Background

Increased urinary albumin/creatinine ratio (uACR) is independently associated with renal disease progression. UACR reduction improves cardiorenal prognosis. Data for the effect of renal denervation (RDN) on uACR is scarce.

Methods

The Global SYMPLICITY Registry enrolled real-world patients undergoing radiofrequency (RF) RDN with Symplicity RDN system (Medtronic, Plc). Patients with microalbuminuria (uACR 30-299 mg/g) or macroalbuminuria (uACR ≥300mg/g) at baseline were analyzed. UACR was reassessed 3-24 months after RDN. Percentage change in geometric mean of uACR from baseline to follow-up was calculated. Kaplan–Meier estimates for time-to-first cardiorenal composite endpoint (all cause death, new onset end-stage kidney disease [eGFR <15mL/min/1.73m² or dialysis], ≥40% decline in eGFR, myocardial infarction, stroke, hospitalization with heart failure) was compared between micro- and macroalbuminuria groups, through 2yrs.

Results

555 patients had uACR evaluable at baseline; 125 (23%) patients had microalbuminuria (median uACR 69 [IQR: 46-128] mg/g) with mean eGFR 77 mL/min/1.73 m², and 56 (10%) patients had macroalbuminuria (median uACR 829 [IQR: 437 - 1966] mg/g) with mean eGFR 56 mL/min/1.73 m². At baseline, the microalbuminuria group had office systolic blood pressure (OSBP) 168±23 mmHg, and 42% had diabetes. In the macroalbuminuria group, OSBP was 166±26 mmHg, 63% had diabetes.

2yrs after RDN, uACR significantly reduced by 50% (95% CI: -68%, -23%) and 66% (95% CI: -82%, -33%) in the micro- and macroalbuminuria groups, respectively (Figure). OSBP reduced by 21.9±26.6 mmHg and 16.0±24.4 mmHg in the micro- and macroalbuminuria groups, respectively. Microalbuminuria group had few cardiorenal events, and significantly less than the macroalbuminuria group (Figure).

Conclusion

Significant uACR reductions were observed after RF RDN. The microalbuminuria group compared to the macroalbuminuria group had significantly less cardiorenal events, highlighting the prognostic importance of uACR reduction. Further prospective study is warranted.

Funding

• Commercial Support – Medtronic