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Renal denervation

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https://www.readbyqxmd.com/read/28220472/renal-denervation-for-resistant-hypertension
#1
REVIEW
Giuseppe Coppolino, Anna Pisano, Laura Rivoli, Davide Bolignano
BACKGROUND: Resistant hypertension is highly prevalent among the general hypertensive population and the clinical management of this condition remains problematic. Different approaches, including a more intensified antihypertensive therapy, lifestyle modifications, or both, have largely failed to improve patients' outcomes and to reduce cardiovascular and renal risk. As renal sympathetic hyperactivity is a major driver of resistant hypertension, renal sympathetic ablation (renal denervation) has been recently proposed as a possible therapeutic alternative to treat this condition...
February 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28220244/resetting-of-renal-tissular-renin-angiotensin-and-bradykinin-kallikrein-systems-after-unilateral-kidney-denervation-in-rats
#2
Jürgen M Bohlender, Jürg Nussberger, Frédéric Birkhäuser, Eric Grouzmann, George N Thalmann, Hans Imboden
The renal tissular renin-angiotensin and bradykinin-kallikrein systems control kidney function together with the renal sympathetic innervation but their interaction is still unclear. To further elucidate this relationship, we investigated these systems in rats 6 days after left kidney denervation (DNX, n = 8) compared to sham-operated controls (CTR, n = 8). Plasma renin concentration was unchanged in DNX vs. CTR (p = NS). Kidney bradykinin (BK) and angiotensin (Ang) I and II concentrations decreased bilaterally in DNX vs...
February 20, 2017: Histochemistry and Cell Biology
https://www.readbyqxmd.com/read/28215245/effects-of-renal-sympathetic-denervation-on-blood-pressure-sleep-apnoea-severity-and-metabolic-indices-a-prospective-cohort-study
#3
Florrie Daniels, Simon De Freitas, Andrew Smyth, John Garvey, Conor Judge, John Joseph Gilmartin, Faisal Sharif
BACKGROUND: Catheter-based renal sympathetic denervation (RSD) significantly reduces blood pressure in patients with resistant hypertension, who commonly have obstructive sleep apnoea (OSA). These patients are considered particularly responsive to the antihypertensive effects of RSD, but additional benefits of metabolic control on sleep apnoea severity have not been thoroughly investigated. METHODS: The effect of RSD was evaluated prospectively in a cohort of patients with OSA (apnoea-hypopnea index (AHI) ≥15 events per hour and an Epworth Sleepiness Scale (ESS) score ≤9) and treatment resistant hypertension...
February 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28212603/effects-of-renal-denervation-on-cardiac-oxidative-stress-and-local-activity-of-the-sympathetic-nervous-system-and-renin-angiotensin-system-in-acute-myocardial-infracted-dogs
#4
Qiaoli Feng, Chengzhi Lu, Li Wang, Lijun Song, Chao Li, Ravi Chandra Uppada
BACKGROUND: This study sought to evaluate the therapeutic effects of renal denervation (RDN) on acute myocardial infarction (MI) in canines and explore its possible mechanisms of action. METHODS: Eighteen healthy mongrel dogs were randomly assigned to either the control group, the MI group or the MI + RDN group. To assess cardiac function, left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic dimension (LVESD) and fraction shortening (FS) were recorded...
February 17, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28187460/effects-of-renal-denervation-on-monocrotaline-induced-pulmonary-remodeling
#5
Qian Liu, Jiyang Song, Dasheng Lu, Jie Geng, Zhixin Jiang, Kai Wang, Bin Zhang, Qijun Shan
Pulmonary artery hypertension (PAH) is a rapidly progressive disorder, which leads to right heart failure and even death. Overactivity of the renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system accounts for the development and progression of PAH. The role of renal denervation (RDN) in different periods of PAH has not been fully elucidated. A single intraperitoneal injection of monocrotaline (MCT, 60 mg/kg) was used to induce pulmonary remodeling in male Sprague Dawley rats (n = 40). After 24-hour of MCT administration, a subset of rats underwent RDN (RDN24h, n = 10); after 2-week of MCT injection, another ten rats received RDN treatment (RDN2w, n = 10) and the left 20 rats were divided to MCT group with sham RDN operation (MCT, n = 20)...
February 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28181735/the-innervation-of-the-kidney-in-renal-injury-and-inflammation-a-cause-and-consequence-of-deranged-cardiovascular-control
#6
REVIEW
Mohammed H Abdulla, Edward J Johns
Extensive investigations have revealed that renal sympathetic nerves regulate renin secretion, tubular fluid reabsorption and renal haemodynamics which can impact on cardiovascular homoeostasis normally and in pathophysiological states. The significance of the renal afferent innervation and its role in determining the autonomic control of the cardiovascular system is uncertain. The transduction pathways at the renal afferent nerves have been shown to require pro-inflammatory mediators and TRPV1 channels. Reno-renal reflexes have been described, both inhibitory and excitatory, demonstrating that a neural link exists between kidneys and may determine the distribution of excretory and haemodynamic function between the two kidneys...
February 9, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28159317/novel-treatment-protocol-for-ameliorating-refractory-chronic-pain-in-patients-with-autosomal-dominant-polycystic-kidney-disease
#7
Niek F Casteleijn, Maatje D A van Gastel, Peter J Blankestijn, Joost P H Drenth, Rosa L de Jager, Anna M Leliveld, Ruud Stellema, Andreas P Wolff, Gerbrand J Groen, Ron T Gansevoort
Autosomal dominant polycystic kidney disease (ADPKD) patients can suffer from chronic pain that can be refractory to conventional treatment, resulting in a wish for nephrectomy. This study aimed to evaluate the effect of a multidisciplinary treatment protocol with sequential nerve blocks on pain relief in ADPKD patients with refractory chronic pain. As a first step a diagnostic, temporary celiac plexus block with local anesthetics was performed. If substantial pain relief was obtained, the assumption was that pain was relayed via the celiac plexus and major splanchnic nerves...
January 31, 2017: Kidney International
https://www.readbyqxmd.com/read/28158510/reduced-blood-pressure-lowering-effect-of-catheter-based-renal-denervation-in-patients-with-isolated-systolic-hypertension-data-from-symplicity-htn-3-and-the-global-symplicity-registry
#8
Felix Mahfoud, George Bakris, Deepak L Bhatt, Murray Esler, Sebastian Ewen, Martin Fahy, David Kandzari, Kazuomi Kario, Giuseppe Mancia, Michael Weber, Michael Böhm
No abstract text is available yet for this article.
January 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28154583/renal-denervation-for-chronic-heart-failure-background-and-pathophysiological-rationale
#9
REVIEW
Michael Böhm, Sebastian Ewen, Felix Mahfoud
The activation of the sympathetic nervous system is associated with cardiovascular hospitalizations and death in heart failure. Renal denervation has been shown to effectively reduce sympathetic overdrive in certain patients with uncontrolled hypertension. Pilot trials investigating renal denervation as a potential treatment approach for heart failure were initiated. Heart failure comorbidities like obstructive sleep apnea, metabolic syndrome and arrhythmias could also be targets for renal denervation, because these occurrences are also mediated by the activation of the sympathetic nervous system...
January 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28146462/first%C3%A2-in%C3%A2-man-experience-with-renal-denervation-of-multiple-renal-arteries-in-a-patient-with-solitary-kidney-and-resistant-hypertension
#10
Olga Możeńska, Marek Rosiak, Aneta Gziut, Robert J Gil, Dariusz A Kosior
No abstract text is available yet for this article.
January 31, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28143710/hepatic-and-renal-mechanisms-underlying-the-osmopressor-response
#11
Tu H Mai, Emily M Garland, André Diedrich, David Robertson
Increased blood pressure (BP) is observed in patients with impaired baroreflexes after water drinking. The stimulus for this effect is low blood osmolality, and it has been termed the osmopressor response (OPR). The BP increase is associated with activation of the sympathetic nervous system and a requirement for transient receptor potential vanilloid 4 (TRPV4) channels. However, the mechanisms underlying the OPR are poorly understood. We tested the hypothesis that hypotonicity is sensed in the portal area to initiate the OPR...
January 27, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28126465/the-role-of-renal-sympathetic-nerves-in-ischemia-reperfusion-injury
#12
REVIEW
Elisabeth Lambert, Markus Schlaich
Decreased blood flow supply to the kidneys known as renal ischemia/reperfusion is a common occurrence during various clinical and surgical settings. This remains highly concerning as it is a major cause of acute kidney injury (AKI). The kidneys have a rich supply of efferent and afferent sympathetic nerves playing a crucial physiological role in regulation of renal function. Studies in animal models of renal ischemia/reperfusion injury have indicated that very early during an ischemic event, the sympathetic nerves are activated and in concert with decreased nitric oxide availability, increased angiotensin II and several other molecules results in renal damage...
January 17, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28118281/renal-denervation-in-comparison-with-intensified-pharmacotherapy-in-true-resistant-hypertension-2-year-outcomes-of-randomized-prague-15-study
#13
Ján Rosa, Petr Widimský, Petr Waldauf, Tomáš Zelinka, Ondřej Petrák, Miloš Táborský, Marian Branny, Petr Toušek, Karol Čurila, Lukáš Lambert, František Bednář, Robert Holaj, Branislav Štrauch, Jan Václavík, Eva Kociánová, Igor Nykl, Otakar Jiravský, Gabriela Rappová, Tomáš Indra, Zuzana Krátká, Jiří Widimský
OBJECTIVES: The randomized, multicentre study compared the efficacy of renal denervation (RDN) versus spironolactone addition in patients with true resistant hypertension. We present the 24-month data. METHODS: A total of 106 patients with true resistant hypertension were enrolled in this study: 52 patients were randomized to RDN and 54 patients to the spironolactone addition, with baseline SBP of 159 ± 17 and 155 ± 17 mmHg and average number of drugs 5...
January 23, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28115517/twenty-four-hour-blood-pressure-monitoring-to-predict-and-assess-impact-of-renal-denervation-the-denerhtn-study-renal-denervation-for-hypertension
#14
Philippe Gosse, Antoine Cremer, Helena Pereira, Guillaume Bobrie, Gilles Chatellier, Bernard Chamontin, Pierre-Yves Courand, Pascal Delsart, Thierry Denolle, Caroline Dourmap, Emile Ferrari, Xavier Girerd, Jean Michel Halimi, Daniel Herpin, Pierre Lantelme, Matthieu Monge, Claire Mounier-Vehier, Jean-Jacques Mourad, Olivier Ormezzano, Jean Ribstein, Patrick Rossignol, Marc Sapoval, Bernard Vaïsse, Faiez Zannad, Michel Azizi
: The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure (BP) lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report here the effect of denervation on 24-hour BP and its variability and look for parameters that predicted the BP response. Patients with resistant hypertension were randomly assigned to denervation plus stepped-care treatment or treatment alone (control)...
March 2017: Hypertension
https://www.readbyqxmd.com/read/28115511/predictive-role-of-nighttime-blood-pressure-in-response-to-renal-denervation-evidence-from-the-dener-htn-study-renal-denervation-for-hypertension
#15
EDITORIAL
https://www.readbyqxmd.com/read/28106665/effects-of-multielectrode-renal-denervation-on-elevated-sympathetic-nerve-activity-and-insulin-resistance-in-metabolic-syndrome
#16
Costas Tsioufis, Kyriakos Dimitriadis, Alexandros Kasiakogias, Theodore Kalos, Ioannis Liatakis, Evagelia Koutra, Levki Nikolopoulou, Athanasios Kordalis, Rita Omega Ella, Elizabeth Oi-Yan Lau, Guido Grassi, Vasilios Papademetriou, Dimitrios Tousoulis
OBJECTIVE: This study aimed to investigate the effects of renal denervation (RDN) on sympathetic nerve activity and insulin resistance in patients with metabolic syndrome. METHODS: Seventeen patients fulfilled at least four of five criteria for metabolic syndrome and under stable use of at least two antihypertensive drugs were randomized in 3 : 1 ratio to RDN (n = 13, 12 men, age: 58 ± 7 years) and control groups (n = 4, three men, age: 60 ± 5 years) and followed up for 3 months...
January 18, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28104100/pathophysiologic-mechanisms-in-heart-failure-role-of-the-sympathetic-nervous-system
#17
Steve Antoine, Gaurang Vaidya, Haider Imam, Daniel Villarreal
The syndrome of heart failure involves complex pathophysiologic mechanisms and is associated with extremely high-morbidity, mortality and economic costs. This growing global epidemic has diverse etiologies and is fundamentally characterized by dyshomeostasis between heart and kidneys, leading to development and progression of the cardiorenal syndrome. Excessive and sustained sympathoexcitation has emerged as a single prominent factor involved in the structural and functional dysfunction of multiple organ systems during this disease...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28089459/effect-of-renal-denervation-on-kidney-function-in-patients-with-chronic-kidney-disease
#18
Dagmara Hering, Petra Marusic, Jacqueline Duval, Yusuke Sata, Geoffrey A Head, Kate M Denton, Sally Burrows, Antony S Walton, Murray D Esler, Markus P Schlaich
AIMS: Renal denervation (RDN) can reduce blood pressure (BP) and slow the decline of renal function in chronic kidney disease (CKD) up to one year. Whether this effect is maintained beyond 12months and whether the magnitude of BP reduction affects estimated glomerular filtration rate (eGFR) is unknown. METHODS AND RESULTS: We examined eGFR in 46 CKD patients (baseline eGFR ≤60mL/min/1.73m(2)) on a yearly basis from 60months before to 3, 6, 12 and 24months after RDN...
January 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28079050/bipolar-radiofrequency-renal-denervation-with-the-vessix-catheter-in-patients-with-resistant-hypertension-2-year-results-from-the-reduce-htn-trial
#19
H Sievert, J Schofer, J Ormiston, U C Hoppe, I T Meredith, D L Walters, M Azizi, J Diaz-Cartelle
No abstract text is available yet for this article.
January 12, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28052866/renal-denervation-in-male-rats-with-heart-failure-improves-ventricular-sympathetic-nerve-innervation-and-function
#20
Maximilian Ichabod Pinkham, Michael T Loftus, Satya Amirapu, Sarah-Jane Guild, Gina Quill, William R Woodward, Beth A Habecker, Carolyn J Barrett
Heart failure is characterized by the loss of sympathetic innervation to the ventricles, contributing to impaired cardiac function and arrhythmogenesis. We hypothesized that renal denervation (RDx) would reverse this loss. Male Wistar rats underwent myocardial infarction (MI) or sham surgery and progressed into heart failure for four weeks before receiving bilateral RDx or sham RDx. After a further three weeks, left ventricular (LV) function was assessed and ventricular sympathetic nerve fibre density determined via histology...
January 4, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
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