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Renal denervation

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https://www.readbyqxmd.com/read/29316564/primary-prevention-of-stroke-in-chronic-kidney-disease-patients-a-scientific-update
#1
Stefana Catalina Bilha, Alexandru Burlacu, Dimitrie Siriopol, Luminita Voroneanu, Adrian Covic
BACKGROUND: Although chronic kidney disease (CKD) is an independent risk factor for stroke, official recommendations for the primary prevention of stroke in CKD are generally lacking. SUMMARY: We searched PubMed and ISI Web of Science for randomised controlled trials, observational studies, reviews, meta-analyses and guidelines referring to measures of stroke prevention or to the treatment of stroke-associated risk factors (cardiovascular disease in general and atrial fibrillation (AF), arterial hypertension or carotid artery disease in particular) among the CKD population...
January 9, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29316186/organ-damage-changes-in-patients-with-resistant-hypertension-randomized-to-renal-denervation-or-spironolactone-the-denervhta-denervaci%C3%A3-n-en-hipertensi%C3%A3-n-arterial-study
#2
Anna Oliveras, Pedro Armario, Laia Sans, Albert Clarà, Susana Vázquez, Luis Molina, Júlia Pareja, Alejandro de la Sierra, Julio Pascual
Renal denervation and spironolactone have both been proposed for the treatment of resistant hypertension, but their effects on preclinical target organ damage have not been compared. Twenty-four patients with 24-hour systolic blood pressure ≥140 mm Hg despite receiving three or more full-dose antihypertensive drugs, one a diuretic, were randomized to receive spironolactone or renal denervation. Changes in 24-hour blood pressure, urine albumin excretion, arterial stiffness, carotid intima-media thickness, and left ventricular mass index were evaluated at 6 months...
January 5, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29287767/resistant-hypertension-renal-denervation-or-intensified-medical-treatment
#3
REVIEW
Alberto Morganti, Giuseppe Mancia
Resistant hypertension (RH) can be diagnosed if blood pressure (BP) is not controlled with the combination of three antihypertensive drugs, including a diuretic, all at effective doses. Patients affected by this condition exhibit a marked increase in the risk of cardiovascular and renal morbid and fatal events. They also exhibit an increased activity of the sympathetic nervous system which is likely to importantly contribute at the renal and other vascular levels to the hypertensive state. Almost 10years ago renal denervation (RDN) by radiofrequency thermal energy delivery to the walls of the renal arteries was proposed for the treatment of RH...
December 27, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29279521/influence-of-renal-sympathetic-denervation-in-patients-with-early-stage-heart-failure-versus-late-stage-heart-failure
#4
Jie Geng, Chun Chen, Xiujuan Zhou, Weichong Qian, Qijun Shan
Renal sympathetic denervation (RDN) is currently being investigated in multiple studies of heart failure (HF). Our aim was to assess the safety and effectiveness of RDN in patients with HF, and determine which patients could achieve more beneficial effects of RDN. A total of 17 consecutive patients with HF were enrolled in the study. Clinical symptoms, office blood pressure, and laboratory results were obtained and echocardiography was performed before and 12 months after RDN. Changes from baseline to 12 months were analyzed for all patients and for two subgroups based on HF duration (group 1: HF duration ≤ 3 years, n = 9; group 2: HF duration > 3 years, n = 8)...
December 27, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29230587/arterial-wall-hypertrophy-is-ameliorated-by-%C3%AE-2-adrenergic-receptor-antagonist-or-aliskiren-in-kidneys-of-angiotensinogen-knockout-mice
#5
Haruka Nakamori, Shin-Ichiro Yoshida, Hiroaki Ishiguro, Shota Suzuki, Hiroaki Yasuzaki, Tatsuo Hashimoto, Tomoaki Ishigami, Nobuhito Hirawa, Yoshiyuki Toya, Satoshi Umemura, Kouichi Tamura
BACKGROUND: Arterial hypertrophy and interstitial fibrosis are important characteristics in kidneys of angiotensinogen-knockout (Atg -/-) mice. In these mice, which exhibit polyuria and hypotension, sympathetic nerve signaling is estimated to be compensatorily hyperactive. Furthermore, transforming growth factor (TGF)-β1 is overexpressed in mice kidneys. To determine whether sympathetic nerve signaling and TGF-β1 exacerbate arterial hypertrophy and interstitial fibrosis, intervention studies of such signaling are required...
December 11, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29225807/renal-denervation-using-carbon-dioxide-renal-angiography-in-patients-with-uncontrolled-hypertension-and-moderate-to-severe-chronic-kidney-disease
#6
Mohammed Awais Hameed, Jonathan S Freedman, Richard Watkin, Arul Ganeshan, Indranil Dasgupta
Background: Chronic kidney disease (CKD) is the most common cause of secondary hypertension. More than half of the patients have uncontrolled hypertension (≥140/90 mmHg on three or more antihypertensive agents at optimum doses). Renal sympathetic denervation (RSDN) has been shown to reduce blood pressure (BP) in patients with resistant hypertension. Although patients with CKD have high sympathetic drive, all major clinical trials have excluded patients with estimated glomerular filtration rates (eGFRs) <45 mL/min/1...
December 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29225806/renal-artery-intervention-utilizing-carbon-dioxide-angiography
#7
EDITORIAL
Alan A Sag, Baris Afsar, Mehmet Kanbay
Carbon dioxide angiography is an established non-nephrotoxic option for imaging of the infradiaphragmatic arteries and veins. Safe performance of the technique once required a somewhat cumbersome system, however, recent innovations have simplified implementation and expanded the user base for this technique. As such, patient access has also increased. In this issue, Hameed et al. provide initial feasibility data regarding carbon dioxide angiography and renal denervation therapy. This experience may be translated into future renovascular interventions in patients with limited renal reserve...
December 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29224639/a-multinational-clinical-approach-to-assessing-the-effectiveness-of-catheter-based-ultrasound-renal-denervation-the-radiance-htn-and-require-clinical-study-designs
#8
RANDOMIZED CONTROLLED TRIAL
Laura Mauri, Kazuomi Kario, Jan Basile, Joost Daemen, Justin Davies, Ajay J Kirtane, Felix Mahfoud, Roland E Schmieder, Michael Weber, Shinsuke Nanto, Michel Azizi
Catheter-based renal denervation is a new approach to treat hypertension via modulation of the renal sympathetic nerves. Although nonrandomized and small, open-label randomized studies resulted in significant reductions in office blood pressure 6months after renal denervation with monopolar radiofrequency catheters, the first prospective, randomized, sham-controlled study (Symplicity HTN-3) failed to meet its blood pressure efficacy end point. New clinical trials with new catheters have since been designed to address the limitations of earlier studies...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29210862/renal-sympathetic-denervation-in-sweden-a-report-from-the-swedish-registry-for-renal-denervation
#9
Sebastian Völz, Jonas Spaak, Johan Elf, Christina Jägrén, Christer Lundin, Anna Stenborg, Jonas Andersson, Bengt Rundqvist, Thomas Kahan, Bert Andersson
BACKGROUND: Renal denervation (RDN) is a catheter-based intervention to treat patients with resistant hypertension. The biological effects of RDN are not fully understood, and randomized controlled trials have generated conflicting evidence. This report presents data from the Swedish Registry for Renal Denervation, an investigator-driven nationwide registry. PURPOSE: To assess the safety and efficacy of RDN on patients with resistant hypertension in a real-world clinical setting...
January 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29210859/catheter-based-renal-denervation-in-hypertension-heading-for-new-shores
#10
Felix Mahfoud, Michael Böhm, Elazer R Edelman
No abstract text is available yet for this article.
January 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29202826/autonomic-nervous-system-involvement-in-pulmonary-arterial-hypertension
#11
REVIEW
Mylène Vaillancourt, Pamela Chia, Shervin Sarji, Jason Nguyen, Nir Hoftman, Gregoire Ruffenach, Mansoureh Eghbali, Aman Mahajan, Soban Umar
Pulmonary arterial hypertension (PAH) is a chronic pulmonary vascular disease characterized by increased pulmonary vascular resistance (PVR) leading to right ventricular (RV) failure. Autonomic nervous system involvement in the pathogenesis of PAH has been demonstrated several years ago, however the extent of this involvement is not fully understood. PAH is associated with increased sympathetic nervous system (SNS) activation, decreased heart rate variability, and presence of cardiac arrhythmias. There is also evidence for increased renin-angiotensin-aldosterone system (RAAS) activation in PAH patients associated with clinical worsening...
December 4, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29172730/renal-sympathetic-denervation-lowers-arterial-pressure-in-canines-with-obesity-induced-hypertension-by-regulating-gad65-and-at1r-expression-in-rostral-ventrolateral-medulla
#12
Zhijie Shen, Chunyan Weng, Zhihui Zhang, Xiaoyan Wang, Kan Yang
To explore the roles of glutamate acid decarboxylase 65 (GAD65) and angiotensin II type 1 receptor (AT1R) in the action of renal sympathetic denervation (RSD) on obesity-induced hypertension in canines. Thirty-two beagles were randomly divided into a hypertensive model (n = 22) and control (n = 10) groups. A hypertensive canine model was established by feeding a high-fat diet. Twenty hypertensive beagles were randomized equally to a sham-surgery and RSD-treated group receiving catheter-based radiofrequency RSD...
November 27, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29151569/what-kind-of-incision-should-be-made-to-reduce-the-risk-of-incisional-hernia-in-kidney-transplantation
#13
Ihsan Yildız, Yavuz Savas Koca
BACKGROUND The incidence of incisional hernia following renal transplantation is 1.1% to 3.8%. The risk factors are immunosuppressive medications, impaired tissue quality, neuromuscular trauma due to the operation, and denervation. The incidence has been decreasing based on the shift from hockey-stick incision method to inguinal oblique incision method. The aim of this study was to minimize the development of incisional hernias due to renal transplantation. MATERIAL AND METHODS Twenty-four patients who underwent renal transplantation in 2015-2017 were retrospectively examined...
November 20, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29104628/renal-sympathetic-denervation-improves-myocardial-apoptosis-in-rats-with-isoproterenol-induced-heart-failure-by-downregulation-of-tumor-necrosis-factor-%C3%AE-and-nuclear-factor-%C3%AE%C2%BAb
#14
Wei Yao, Neng Wang, Jin Qian, Lu Bai, Xiaoxin Zheng, Guo Hou, Xuan Qiu, Bo Yang
Chronic congestive heart failure (CHF) is the end outcome of organic heart diseases and one of the major diseases harmful to human health. Renal sympathetic denervation (RSD) is the anatomical basis of transcatheter renal sympathetic nerve ablation within the renal artery. To date, the roles of norepinephrine and angiotensin II (Ang II) in myocardial apoptosis and their underlying mechanisms have not been well explored. The aim of the present study was to verify the hypothesis that RSD is likely to inhibit myocardial apoptosis by inhibiting the release of norepinephrine and Ang II...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29094471/antifibrillatory-effects-of-renal-denervation-on-ventricular-fibrillation-in-a-canine-model-of-pacing-induced-heart-failure
#15
Qingzhi Luo, Qi Jin, Ning Zhang, Shangwei Huang, Yanxin Han, Changjian Lin, Tianyou Ling, Kang Chen, Wenqi Pan, Liqun Wu
This study investigated the effects of renal denervation (RDN) on vulnerability to ventricular fibrillation (VF) and ventricular electrical properties in a canine model of pacing-induced heart failure (HF). Eighteen beagles were divided into the following three groups: control (n = 6), HF (n = 6) and HF+RDN (n = 6). HF was induced by rapid right ventricular pacing. RDN was performed simultaneously with the pacemaker implantation in the HF+RDN group. A 64-unipolar basket catheter was used to perform global endocardial mapping of the left ventricle...
November 2, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/29082259/effects-of-renal-denervation-on-insulin-sensitivity-and-inflammatory-markers-in-nondiabetic-patients-with-treatment-resistant-hypertension
#16
Ulla Kampmann, Ole N Mathiassen, Kent L Christensen, Niels H Buus, Mette Bjerre, Henrik Vase, Niels Møller, Anne Kaltoft, Per L Poulsen
Increased sympathetic activity is important in the pathogenesis of hypertension and insulin resistance. Afferent signaling from the kidneys elevates the central sympathetic drive. We investigated the effect of catheter-based renal sympathetic denervation (RDN) on glucose metabolism, inflammatory markers, and blood pressure in nondiabetic patients with treatment-resistant hypertension. Eight subjects were included in an open-labelled study. Each patient was studied before and 6 months after RDN. Endogenous glucose production was assessed by a 3-(3)H glucose tracer, insulin sensitivity was examined by hyperinsulinemic euglycemic clamp, hormones and inflammatory markers were analyzed, and blood pressure was measured by office blood pressure readings and 24-hour ambulatory blood pressure monitoring...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/29070043/the-effect-of-renal-denervation-in-an-experimental-model-of-chronic-renal-insufficiency-the-remnant-kidney-denervation-in-pigs-study-redip-study
#17
Jean-Claude Lubanda, Miroslav Chochola, Mikuláš Mlček, Petr Neužil, Josef Marek, Štěpán Havránek, Sylvie Kuchynková, Zdeňka Fingrová, Kao-Hsuan Aimee Huang, Aleš Linhart
BACKGROUND: Renal denervation (RDN) is a promising therapeutic method in cardiology. Its currently most investigated indication is resistant hypertension. Other potential indications are atrial fibrillation, type 2 diabetes mellitus and chronic renal insufficiency among others. Previous trials showed conflicting but promising results, but the real benefits of RDN are still under investigation. Patients with renal insufficiency and resistant hypertension are proposed to be a good target for this therapy due to excessive activation of renal sympathetic drive...
October 25, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29069927/how-to-perform-a-cost-effectiveness-analysis-with-surrogate-endpoint-renal-denervation-in-patients-with-resistant-hypertension-denerhtn-trial-as-an-example
#18
Julie Bulsei, Meryl Darlington, Isabelle Durand-Zaleski, Michel Azizi
Whilst much uncertainty exists as to the efficacy of renal denervation (RDN), the positive results of the DENERHTN study in France confirmed the interest of an economic evaluation in order to assess efficiency of RDN and inform local decision makers about the costs and benefits of this intervention. The uncertainty surrounding both the outcomes and the costs can be described using health economic methods such as the non-parametric bootstrap. Internationally, numerous health economic studies using a cost-effectiveness model to assess the impact of RDN in terms of cost and effectiveness compared to antihypertensive medical treatment have been conducted...
October 26, 2017: Blood Pressure
https://www.readbyqxmd.com/read/29061728/central-iliac-arteriovenous-anastomosis-for-uncontrolled-hypertension-one-year-results-from-the-rox-control-htn-trial
#19
RANDOMIZED CONTROLLED TRIAL
Melvin D Lobo, Christian Ott, Paul A Sobotka, Manish Saxena, Alice Stanton, John R Cockcroft, Neil Sulke, Eamon Dolan, Markus van der Giet, Joachim Hoyer, Stephen S Furniss, John P Foran, Adam Witkowski, Andrzej Januszewicz, Danny Schoors, Konstantinos Tsioufis, Benno J Rensing, Benjamin Scott, G André Ng, Roland E Schmieder
Creation of a central iliac arteriovenous anastomosis using a novel nitinol coupler device results in an immediate, significant reduction of blood pressure (BP). We present efficacy and safety findings at 12 months post-coupler insertion. This open-label, multicenter, prospective, randomized trial enrolled patients with a baseline office systolic BP ≥140 mm Hg and average daytime ambulatory BP ≥135/85 mm Hg. Subjects were randomly allocated to coupler implantation and continuing previous pharmacotherapy or to maintain previous treatment alone...
December 2017: Hypertension
https://www.readbyqxmd.com/read/29059859/increased-arterial-stiffness-does-not-respond-to-renal-denervation-in-an-animal-model-of-secondary-hypertension
#20
Yimin Yao, Cara M Hildreth, Sheran Li, Rochelle Boyd, Zahra Kouchaki, Mark Butlin, Alberto P Avolio, Paul M Pilowsky, Jacqueline K Phillips
Renal denervation is a novel device based therapy promoted to reduce high blood pressure. We examined the impact of renal denervation on systolic blood pressure, renal function, and arterial stiffness in the Lewis Polycystic Kidney disease (LPK) rodent model of kidney disease. Animals were subjected to bilateral renal denervation or sham surgeries at age 6 and 12 weeks. Systolic blood pressure was monitored by tail-cuff plethysmography and renal function by urinalysis and creatinine clearance. At age 16 weeks, beat-to-beat aortic pulse wave velocity as a functional indicator of arterial stiffness was determined...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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