8b.07: Results from the Uk Renal Denervation Affiliation- 246 Cases from 17 Centres

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Authors
Sharp, Andrew
Hameed, A.
Nightingale, A.
Martin, U.
Mark, P.
McKane, W.
Cunnington, M.
Lobo, M.
Mahadevan, K.
Richardson, T.
Journal
Journal of hypertension
Type
Conference abstract
Publisher
Wolters Kluwer
Rights
OBJECTIVE: To describe the UK experience with Renal Denervation (RDN). DESIGN AND METHOD: RDN may lower blood pressure (BP) in people with resistant hypertension.The UK Renal Denervation Affiliation is an independent, investigator-led initiative. Each centre had done >5 cases. A standardised dataset was collected retrospectively, anonymised and submitted to the coordinating centre for analysis. RESULTS: Results from 246 cases from 16 centres are reported. Average cases per centre was 15. Five different ablation technologies were used: unipolar catheters in 198 and multipolar in 48.Mean age was 56.7 years, 53% female, 87% Caucasian and 27% diabetes. Previous stroke/TIA - 24%; myocardial infarction - 15%; proteinuria - 26%.Patients were screened by a mean of 1.6 specialists with an interest in hypertension. 86% attended specialist hypertension clinics.On average 4.7 drugs were used before RDN; 95% were on 3+ drugs; 90% were on RAS blockers, 90% diuretics and 56% aldosterone antagonists at time of RDN.Pre-RDN mean office BP was 186/102 mmHg. Ambulatory blood pressure monitoring (ABP) data were available for 179 patients (73%). Average pre-RDN ABP was: daytime - 170/98; night - 154/86.Average follow-up was 10.7 months. Mean Office BP post-RDN was 164/93, a fall of 22/9 mmHg (P < 0.001). In 24%, office SBP fell 40+ mmHg. On average, 0.8 drugs were withdrawn per patient and 0.3 drugs added between RDN and follow-up.Mean daytime ABP after RDN was 158/92 and nighttime ABP 145/81 - fall in daytime ABP was 12/6 (p < 0.001). 18% had a drop in day systolic ABP of >20 mmHg. A decrease in GFR >25% was seen at 10 months in 5% patients. Otherwise, no significant complications were seen. CONCLUSIONS: In a cohort of 246 patients from 16 UK centres who had undergone renal denervation, a significant fall in blood pressure was observed. Office BP fell by 22/9 mmHg. Daytime ambulatory BP fell by 12/6 mmHg.Carefully selected patients with resistant hypertension exhibited significant BP reduction following RDN. This was a group with severe hypertension who had been well characterised in specialist hypertension clinics. Drug additions/withdrawals did not appear to explain the BP fall.
Citation
J Hypertens. 2015 Jun;33 Suppl 1:e109.
Note