Effects of renal denervation on kidney function in patients with chronic kidney disease: a systematic review and meta-analysis

作者：A. Mohammad, Khaled Nawar, Olivia Binks, M. Abdulla · 发表于：Journal of Human Hypertension · 年份：2023 · DOI：10.1038/s41371-023-00857-3 · 研究领域：Medicine

The present study aims to evaluate the clinical outcomes following renal denervation (RDN) for hypertensive patients with chronic kidney disease (CKD). Prospective studies published between January 1, 2010 and November 15, 2022 where systematically identified for RDN outcomes on office and ambulatory blood pressure, estimated glomerular filtration rate (eGFR), creatinine and procedural characteristics from three online databases (Medline, PubMed, EMBASE). Random effects model to combine risk ratios and mean differences was used. Where possible, clinical outcomes were pooled and analyzed at 6, 12 and 24 months. Significance was set at p  ≤ 0.05. 11 prospective trials, with a total of 226 patients with treatment resistant HTN receiving RDN met the inclusion criteria. Age ranged from 42.5 ± 13.8 to 66 ± 9. Main findings of this review included a reduction in systolic and diastolic office blood pressure at 6 [−19.8 ( p  < 0.00001)/−15.2 mm Hg ( p  < 0.00001)] and 12 months [−21.2 ( p  < 0.00001)/−9.86 mm Hg ( p  < 0.0005)] follow-up compared to baseline. This was also seen in systolic and diastolic 24-hour ambulatory blood pressure at 6 [−9.77 ( p  = 0.05)/−3.64 mm Hg ( p  = 0.09)] and 12 months [−13.42 ( p  = 0.0007)/−6.30 mm Hg ( p  = 0.001)] follow-up compared to baseline. The reduction in systolic and diastolic 24-hour ambulatory blood pressure was maintained to 24 months [(−16.30 ( p  = 0.0002)/−6.84 mm Hg ( p  = 0.0010)]. Analysis of kidney function through eGFR demonstrate...