کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5972280 | 1576188 | 2014 | 5 صفحه PDF | دانلود رایگان |
ObjectivesThe primary objective of this study was the effect of renal denervation (RDN) on elevated urinary albumin-to-creatinine ratio (UACR) in treatment-resistant hypertensive patients. In addition, patients were stratified according their UACR at baseline into micro- (30-300 mg/g, n = 37) and macroalbuminuria (â¥Â 300 mg/g, < 2200 mg/g, n = 22).BackgroundIncreased albuminuria indicates cardiovascular and renal damage in hypertension. RDN emerged as an innovative interventional approach to reduce blood pressure (BP) and may thus reduce albumin urinary excretion.MethodsFifty-nine treatment-resistant hypertensive patients with elevated UACR at baseline underwent catheter-based RDN using the Symplicity Flex⢠catheter (Medtronic Inc., Santa Rosa, CA).ResultsIn the whole and pre-specified subgroups both office and 24-h ambulatory BP were significantly reduced 6 months after RDN. In parallel, a significant reduction in UACR occurred in all patients (160 (65-496) versus 89 (29-319) mg/g creatinine, p < 0.001) and in both subgroups (microalbuminuria: 83 (49-153) versus 58 (17-113) mg/g creatinine, p = 0.001; macroalbuminuria: (536 (434-1483) versus 478 (109-1080) mg/g creatinine, p < 0.001). In accordance, the prevalence of micro- and macroalbuminuria decreased significantly. Regression analysis revealed a modest positive relationship between the decrease of UACR and the fall of systolic BP (β = 0.340, p = 0.039) independent of renal function. Renal function remained unchanged after RDN.ConclusionsIn summary, following RDN, the magnitude of albuminuria as well as the prevalence of micro- and macroalbuminuria decreased in treatment-resistant hypertensive patients. Since albuminuria is an independent renal and cardiovascular risk factor, our findings suggest a reduction of renal and cardiovascular risk in these patients.
Journal: International Journal of Cardiology - Volume 173, Issue 2, 1 May 2014, Pages 311-315