Introduction: Renal denervation (RDN)for the treatment of resistant hypertension is based on the hypothesis that bilateral interruption of the central-sympathetic-nervous-system (SNS) and kidney "cross talk" reduces sympathetic flow and blood pressure (BP). In about ~15% of the cases bilateral RDN is not feasible and unilateral RND (URDN) is than performed at the discretion of the operator.
Objective: To assess the effects of incomlet renal denervation, as performed in URND,q on BP.
Methods: RND centers (n=8) in Europe (n=7) and Israel (n=1) enrolled URDN patients retrospectively.
Pre specified CRFs were filled and collected in a central database.
Results: Patients (n= 31) were mostly males (58%), age 65±12yrs with multiple
co-morbidities; Hyperlipidemia (48%), Diabetes Mellitus (55%), clinically manifested atherosclerosis (41%) and chronic kidney disease (24%). eGRR values were 64±22 ml/min.
Patients were under medical therapy of 4.7±1.5 classes of drugs. URDN was
performed because of renal artery stenosis (31%), non feasible anatomy (20%) and for other various reasons. 5.1±1.5 ablations/patients were performed for cumulative ablation time of 25±22min. At 12 months follow up, systolic BP was significant lower (178±34 vs. 151±28mmHg, p=0.01) while diastolic BP remained unchanged (89±14 vs. 88±18mmHg, p=NS).
Conclusions: URDN seem to lower systolic BP. These findings suggest that even unilateral interruption of renal SNS affects BP. More data is needed to fully explore the clinical role
of URDN. Better understanding of the underlying pathophysiology of RND is needed.
