Favorable effect of renal denervation on elevated renal vascular resistance in patients with resistant hypertension and type 2 diabetes mellitus
ObjectiveTo assess the effect of renal denervation (RDN) on renal vascular resistance and renal function in patients with drug-resistant hypertension (HTN) and type 2 diabetes mellitus (T2DM).Materials and methodsFifty-nine patients (mean age 60.3 ± 7.9 years, 25 men) with resistant HTN [mean 24-h a...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1010546/full |
| _version_ | 1811198004762247168 |
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| author | Musheg Manukyan Alla Falkovskaya Victor Mordovin Stanislav Pekarskiy Irina Zyubanova Ekaterina Solonskaya Tamara Ryabova Simzhit Khunkhinova Anastasia Vtorushina Sergey Popov |
| author_facet | Musheg Manukyan Alla Falkovskaya Victor Mordovin Stanislav Pekarskiy Irina Zyubanova Ekaterina Solonskaya Tamara Ryabova Simzhit Khunkhinova Anastasia Vtorushina Sergey Popov |
| author_sort | Musheg Manukyan |
| collection | DOAJ |
| description | ObjectiveTo assess the effect of renal denervation (RDN) on renal vascular resistance and renal function in patients with drug-resistant hypertension (HTN) and type 2 diabetes mellitus (T2DM).Materials and methodsFifty-nine patients (mean age 60.3 ± 7.9 years, 25 men) with resistant HTN [mean 24-h ambulatory blood pressure (BP) 158.0 ± 16.3/82.5 ± 12.7 mmHg, systolic/diastolic] and T2DM (mean HbA1c 7.5 ± 1.5%) were included in the single-arm prospective study and underwent RDN. Renal resistive index (RRI) derived from ultrasound Doppler; estimated glomerular filtration rate (Chronic Kidney Disease Epidemiology Collaboration formula), office and 24-h ambulatory BP were measured at baseline, 6, and 12 months after RDN to evaluate the respective changes in renal vascular resistance, renal function, and BP during treatment.ResultsForty-three patients completed 12 months follow-up. The RRI changed depending on the baseline value. Specifically, the RRI decreased significantly in patients with elevated baseline RRI values ≥ 0.7 {n = 23; −0.024 [95% confidence interval (CI): −0.046, −0.002], p = 0.035} and did not change in those with baseline RRI < 0.7 [n = 36; 0.024 (95% CI: −0.002, 0.050), p = 0.069]. No significant change was observed in eGFR whereas BP was significantly reduced at 12 months after RDN by −10.9 (95% CI: −16.7, −5.0)/−5.5 (95% CI: −8.7, −2.4) mmHg, systolic/diastolic. No relationship was found between the changes in RRI and BP.ConclusionOur study shows that RDN can decrease elevated renal vascular resistance (RRI > 0.7) and stabilize kidney function in patients with RHTN and T2DM independently of its BP-lowering effect. |
| first_indexed | 2024-04-12T01:23:48Z |
| format | Article |
| id | doaj.art-0ffa45fcbc8348d4913d513024104660 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T01:23:48Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-0ffa45fcbc8348d4913d5130241046602022-12-22T03:53:42ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-12-01910.3389/fcvm.2022.10105461010546Favorable effect of renal denervation on elevated renal vascular resistance in patients with resistant hypertension and type 2 diabetes mellitusMusheg ManukyanAlla FalkovskayaVictor MordovinStanislav PekarskiyIrina ZyubanovaEkaterina SolonskayaTamara RyabovaSimzhit KhunkhinovaAnastasia VtorushinaSergey PopovObjectiveTo assess the effect of renal denervation (RDN) on renal vascular resistance and renal function in patients with drug-resistant hypertension (HTN) and type 2 diabetes mellitus (T2DM).Materials and methodsFifty-nine patients (mean age 60.3 ± 7.9 years, 25 men) with resistant HTN [mean 24-h ambulatory blood pressure (BP) 158.0 ± 16.3/82.5 ± 12.7 mmHg, systolic/diastolic] and T2DM (mean HbA1c 7.5 ± 1.5%) were included in the single-arm prospective study and underwent RDN. Renal resistive index (RRI) derived from ultrasound Doppler; estimated glomerular filtration rate (Chronic Kidney Disease Epidemiology Collaboration formula), office and 24-h ambulatory BP were measured at baseline, 6, and 12 months after RDN to evaluate the respective changes in renal vascular resistance, renal function, and BP during treatment.ResultsForty-three patients completed 12 months follow-up. The RRI changed depending on the baseline value. Specifically, the RRI decreased significantly in patients with elevated baseline RRI values ≥ 0.7 {n = 23; −0.024 [95% confidence interval (CI): −0.046, −0.002], p = 0.035} and did not change in those with baseline RRI < 0.7 [n = 36; 0.024 (95% CI: −0.002, 0.050), p = 0.069]. No significant change was observed in eGFR whereas BP was significantly reduced at 12 months after RDN by −10.9 (95% CI: −16.7, −5.0)/−5.5 (95% CI: −8.7, −2.4) mmHg, systolic/diastolic. No relationship was found between the changes in RRI and BP.ConclusionOur study shows that RDN can decrease elevated renal vascular resistance (RRI > 0.7) and stabilize kidney function in patients with RHTN and T2DM independently of its BP-lowering effect.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1010546/fullrenal denervationrenal functionrenal hemodynamicsrenal resistive indextype 2 diabetes mellitusresistant hypertension |
| spellingShingle | Musheg Manukyan Alla Falkovskaya Victor Mordovin Stanislav Pekarskiy Irina Zyubanova Ekaterina Solonskaya Tamara Ryabova Simzhit Khunkhinova Anastasia Vtorushina Sergey Popov Favorable effect of renal denervation on elevated renal vascular resistance in patients with resistant hypertension and type 2 diabetes mellitus Frontiers in Cardiovascular Medicine renal denervation renal function renal hemodynamics renal resistive index type 2 diabetes mellitus resistant hypertension |
| title | Favorable effect of renal denervation on elevated renal vascular resistance in patients with resistant hypertension and type 2 diabetes mellitus |
| title_full | Favorable effect of renal denervation on elevated renal vascular resistance in patients with resistant hypertension and type 2 diabetes mellitus |
| title_fullStr | Favorable effect of renal denervation on elevated renal vascular resistance in patients with resistant hypertension and type 2 diabetes mellitus |
| title_full_unstemmed | Favorable effect of renal denervation on elevated renal vascular resistance in patients with resistant hypertension and type 2 diabetes mellitus |
| title_short | Favorable effect of renal denervation on elevated renal vascular resistance in patients with resistant hypertension and type 2 diabetes mellitus |
| title_sort | favorable effect of renal denervation on elevated renal vascular resistance in patients with resistant hypertension and type 2 diabetes mellitus |
| topic | renal denervation renal function renal hemodynamics renal resistive index type 2 diabetes mellitus resistant hypertension |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1010546/full |
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