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Renal denervation

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https://www.readbyqxmd.com/read/27908698/potential-role-of-endurance-training-in-altering-renal-sympathetic-nerve-activity-in-ckd
#1
REVIEW
Erin J Howden, Justin S Lawley, Murray Esler, Benjamin D Levine
Chronic kidney disease (CKD), is characterized by a progressive loss of renal function and increase in cardiovascular risk. In this review paper, we discuss the pathophysiology of increased sympathetic nerve activity in CKD patients and raise the possibility of endurance exercise being an effective countermeasure to address this problem. We specifically focus on the potential role of endurance training in altering renal sympathetic nerve activity as increased renal sympathetic nerve activity negatively impacts kidney function as well indirectly effects multiple other systems and organs...
November 25, 2016: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/27906840/renal-artery-denervation-for-treatment-of-patients-with-self-reported-obstructive-sleep-apnea-and-resistant-hypertension-results-from-the-global-symplicity-registry
#2
Dominik Linz, Giuseppe Mancia, Felix Mahfoud, Krzysztof Narkiewicz, Luis Ruilope, Markus Schlaich, Ingrid Kindermann, Roland E Schmieder, Sebastian Ewen, Bryan Williams, Michael Böhm
BACKGROUND: Sleep-disordered breathing, predominantly obstructive sleep apnea (OSA), is highly prevalent in patients with hypertension. OSA may underlie the progression to resistant hypertension, partly due to increased activation of the sympathetic nervous system. This analysis of patients with and without OSA evaluated the blood pressure (BP)-lowering effect of sympathetic modulation by renal denervation (RDN) in a real-world setting. METHODS: The Global SYMPLICITY Registry (NCT01534299) is a prospective, open-label, multicenter registry conducted worldwide to evaluate the safety and effectiveness of RDN in patients with uncontrolled hypertension...
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27905168/editorial-can-renal-denervation-work-yes-but-first-one-must-denervate-lessons-from-human-renal-sympathetic-nerve-anatomy
#3
EDITORIAL
Tim A Fischell
No abstract text is available yet for this article.
December 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27902630/blood-pressure-reduction-after-renal-denervation-in-obese-hypertensive-swine-model
#4
Masayuki Tanemoto
No abstract text is available yet for this article.
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27895136/recognition-and-management-of-resistant-hypertension
#5
REVIEW
Branko Braam, Sandra J Taler, Mahboob Rahman, Jennifer A Fillaus, Barbara A Greco, John P Forman, Efrain Reisin, Debbie L Cohen, Mohammad G Saklayen, S Susan Hedayati
Despite improvements in hypertension awareness and treatment, 30%-60% of hypertensive patients do not achieve BP targets and subsequently remain at risk for target organ damage. This therapeutic gap is particularly important to nephrologists, who frequently encounter treatment-resistant hypertension in patients with CKD. Data are limited on how best to treat patients with CKD and resistant hypertension, because patients with CKD have historically been excluded from hypertension treatment trials. First, we propose a consistent definition of resistant hypertension as BP levels confirmed by both in-office and out-of-office measurements that exceed appropriate targets while the patient is receiving treatment with at least three antihypertensive medications, including a diuretic, at dosages optimized to provide maximum benefit in the absence of intolerable side effects...
November 28, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27890862/randomized-blinded-and-controlled-comparative-study-of-chemical-and-radiofrequency-based-renal-denervation-in-a-porcine-model
#6
Stefan Bertog, Tim A Fischell, Félix Vega, Vartan Ghazarossian, Atul Pathak, Laura Vaskelyte, Darrin Kent, Horst Sievert, Elena Ladich, Kazuyuki Yahagi, Renu Virmani
AIMS: The blood pressure lowering effect of percutaneous renal denervation (RDN) is controversial. Success of RDN may be device-dependent. We sought to compare the efficacy of RDN by chemical neurolysis using alcohol (Peregrine System™ Infusion Catheter, Ablative Solutions, Inc. Menlo Park, CA, USA) to RDN by radiofrequency (RF) ablation with the single-electrode RF catheter (Symplicity™ Flex, Medtronic Inc., Minneapolis, MN, USA) in a porcine model. METHODS AND RESULTS: This was a prospective, randomized, blinded study...
November 29, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27890860/renal-denervation-by-ct-guided-periarterial-injection-of-hyperosmolar-saline-vincristine-paclitaxel-and-guanethidine-in-a-pig-model
#7
Patrick Freyhardt, Ricardo Donners, Alex Riemert, Jörg Schnorr, Nicola Stolzenburg, Jan Leo Rinnenthal, Ulrich Bernhardt, Bernd Hamm, Rolf W Günther, Florian Streitparth
AIMS: To evaluate feasibility, safety and efficacy of renal sympathetic denervation with CT- guided periarterial injection of potentially neurolytic agents in pigs. METHODS AND RESULTS: Unilateral injection of formulations containing either 5 M hyperosmolar saline, vincristine, paclitaxel or guanethidine around the renal artery was performed in 24 normotensive pigs with 6 animals per group. Needle placement and injections were performed under CT-fluoroscopy guidance...
November 29, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27890739/novel-insights-into-the-mechanisms-of-renal-sympathetic-denervation-induced-neuromodulation-in-controlling-atrial-arrhythmias-in-canines
#8
EDITORIAL
Annemiek F Hoogerwaard, Arif Elvan
No abstract text is available yet for this article.
November 23, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27889753/renal-denervation-attenuates-multi-organ-fibrosis-and-improves-vascular-remodeling-in-rats-with-transverse-aortic-constriction-induced-cardiomyopathy
#9
Kai Wang, Dasheng Lu, Bin Zhang, Shengchan Wang, Qian Liu, Qi Zhang, Jie Geng, Qijun Shan
BACKGROUND/AIMS: To investigate the effects of renal denervation (RDN) on multi-organ fibrosis and vascular remodeling in cardiomyopathy. METHODS: Thirty-six male Sprague-Dawley rats underwent transverse aortic constriction (TAC). Five weeks later, 28 surviving TAC rats were randomly assigned to three groups: (1) RDN, (2) Sham, (3) Carvedilol. Six male Sham TAC rats served as the Control. Ten weeks after TAC, samples were collected. RESULTS: TAC rats showed an increased diastolic interventricular septal thickness at week 5...
November 25, 2016: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/27865077/renal-sympathetic-denervation-recalculating%C3%A2
#10
EDITORIAL
Jorge A Belardi, Mariano Albertal
No abstract text is available yet for this article.
November 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27856353/urolithiasis-in-renal-transplant-donors-and-recipients-an-update
#11
REVIEW
Ahmed M Harraz, Ahmed I Kamal, Ahmed A Shokeir
Urolithiasis in the context of renal transplant is a quite rare event that requires keeping a higher index of suspicion and vigilance. Donors with incidentally discovered asymptomatic renal stones "donor gifted lithiasis" are potentially considered for donation should they are not recurrent stone formers and in the absence of active biochemical disorders. Stone clearance from the donors can be done before donation using shock wave lithotripsy and/or flexible ureteroscopy. Ex vivo ureteroscopy at time of transplant is equally feasible and safe...
November 14, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27849014/renal-artery-vasodilation-may-be-an-indicator-of-successful-sympathetic-nerve-damage-during-renal-denervation-procedure
#12
Weijie Chen, Huaan Du, Jiayi Lu, Zhiyu Ling, Yi Long, Yanping Xu, Peilin Xiao, Laxman Gyawali, Kamsang Woo, Yuehui Yin, Bernhard Zrenner
Autonomic nervous system plays a crucial role in maintaining and regulating vessel tension. Renal denervation (RDN) may induce renal artery vasodilation by damaging renal sympathetic fibers. We conducted this animal study to evaluate whether renal artery vasodilation could be a direct indicator of successful RDN. Twenty-eight Chinese Kunming dogs were randomly assigned into three groups and underwent RDN utilizing temperature-controlled catheter (group A, n = 11) or saline-irrigated catheter (group B, n = 11) or sham procedure (group C, n = 6)...
November 16, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27845300/effects-of-renal-sympathetic-denervation-on-cardiac-systolic-function-after-myocardial-infarction-in-rats
#13
Jiqun Guo, Zhongxia Zhou, Zhenzhen Li, Qian Liu, Guoqing Zhu, Qijun Shan
This study investigated the therapeutic effects of renal denervation on cardiac systolic function after myocardial infarction (MI) in rats and the mechanism involved. Fifty male SD rats were randomly assigned to the sham group (n = 15), the MI group (n = 20), and the MI plus renal denervation group (n = 15). MI was established through thoracotomic ligation of the anterior descending artery. Renal denervation was achieved by laparotomic stripping of the renal arterial adventitial sympathetic nerve, approximately 3 mm from the abdominal aorta...
September 2016: Journal of Biomedical Research
https://www.readbyqxmd.com/read/27815927/renal-denervation
#14
Mohammed Awais Hameed, Indranil Dasgupta
Sympathetic nervous system over-activity is closely linked with elevation of systemic blood pressure. Both animal and human studies suggest renal sympathetic nerves play an important role in this respect. Historically, modulation of sympathetic activity has been used to treat hypertension. More recently, catheter based renal sympathetic denervation was introduced for the management of treatment resistant hypertension. Sound physiological principles and surgical precedent underpin renal denervation as a therapy for treatment of resistant hypertension...
November 5, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27811545/from-inflammation-to-renal-denervation-in-hypertension-research
#15
Alberto Zanchetti
No abstract text is available yet for this article.
December 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27789315/renal-denervation-for-resistant-hypertension
#16
REVIEW
John P Reilly, Christopher J White
Renal Denervation for Resistant Hypertension Renal denervation as a treatment for hypertension (HTN) has been shown to be effective as a surgical procedure. Over the past ten years, an endovascular approach to replicate the results of surgical splanchnicectomy has been investigated to replace this surgical procedure with a less invasive procedure with lower morbidity. Several devices and procedures have been developed, including a non-invasive strategy. We review the improvement of HTN in clinical trials of these devices as well as the shortcomings of these studies...
October 24, 2016: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/27788856/regression-to-the-mean-in-symplicity%C3%A2-htn-3-implications-for-design-and-reporting-of-future-trials
#17
REVIEW
Stuart J Pocock, George Bakris, Deepak L Bhatt, Sandeep Brar, Martin Fahy, Bernard J Gersh
Regression to the mean (RTM) describes the tendency for an extreme measurement on 1 occasion to become less extreme when measured again. RTM may affect clinical trial data interpretation when the outcome measure has high variability. We investigated RTM in the SYMPLICITY HTN-3 (Renal Denervation in Patients With Uncontrolled Hypertension) trial of renal denervation versus a sham procedure. Analysis of covariance was performed on the 6-month change in systolic blood pressure, estimating a mean treatment difference of -4...
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27781967/-renal-denervation-as-treatment-option-for-hypertension
#18
P J Blankestijn, M L Bots
The rationale behind catheter-based renal denervation is that afferent and efferent renal nerves play a role in the pathogenesis and maintenance of high blood pressure, and that this can be prevented by blocking the function of the renal nerves. Since the introduction of catheter-based renal denervation, several observational and a small number of randomised controlled trials have been conducted. The available evidence does not allow for a definitive conclusion regarding its efficacy. There have been no serious side-effects reported...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27775435/copeptin-resistant-hypertension-and-renal-sympathetic-denervation
#19
Marius Schwerg, Anna Slagman, Karl Stangl, Verena Stangl
BACKGROUND: Renal denervation is used as a treatment option for patients with resistant hypertension. But only a subgroup of patients benefits from RDN. Biomarkers might be helpful to identify patients who respond to RDN. Copeptin as a surrogate for vasopressin levels is increased in hypertension and other cardiovascular diseases. This study aims to evaluate the effect of RDN on Copeptin and its prognostic value for response to RDN. METHOD AND RESULTS: A total of 40 patients have been included in the study...
October 24, 2016: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/27755390/renal-denervation-reduces-office-and-ambulatory-heart-rate-in-patients-with-uncontrolled-hypertension-12-month-outcomes-from-the-global-symplicity-registry
#20
Michael Böhm, Christian Ukena, Sebastian Ewen, Dominik Linz, Ina Zivanovic, Uta Hoppe, Krzysztof Narkiewicz, Luis Ruilope, Manuela Negoita, Roland Schmieder, Bryan Williams, Uwe Zeymer, Andreas Zirlik, Guiseppe Mancia, Felix Mahfoud
OBJECTIVES: Renal denervation (RDN) can reduce sympathetic activity and blood pressure (BP) in patients with hypertension. The effects on resting and ambulatory heart rate (HR), also regulated by the sympathetic nervous system, are not established. METHODS: Herein, we report 12-month outcomes from the Global SYMPLICITY Registry on office and ambulatory HR and BP in patients with uncontrolled hypertension (n = 846). RESULTS: HR declined in correlation with the HR at baseline and at 12 months, in particular, in patients in the upper tertile of HR (>74 bpm)...
October 15, 2016: Journal of Hypertension
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