Kidney function and markers of renal damage after renal denervation. Does method of measurement matter? The Reshape CV‐Risk Study

Autor: Jon Viljar Norvik, A. Miroslawska, Marit Dahl Solbu, Terje K. Steigen, Bjørn Odvar Eriksen
Rok vydání: 2021
Předmět:
Adult
medicine.medical_specialty
Endocrinology
Diabetes and Metabolism
Urinary system
Urology
Renal function
030204 cardiovascular system & hematology
Kidney
urologic and male genital diseases
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Internal Medicine
Humans
Medicine
urinary biomarkers
030212 general & internal medicine
Renal Insufficiency
Chronic
Original Paper
glomerular filtration rate
Creatinine
biology
urogenital system
business.industry
VDP::Medisinske Fag: 700::Basale medisinske
odontologiske og veterinærmedisinske fag: 710
Middle Aged
Denervation
VDP::Medical disciplines: 700::Basic medical
dental and veterinary science disciplines: 710
Renal Denervation
medicine.anatomical_structure
chemistry
Cystatin C
Hypertension
Ambulatory
biology.protein
Albuminuria
Biomarker (medicine)
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Biomarkers
Zdroj: The Journal of Clinical Hypertension
ISSN: 1751-7176
1524-6175
DOI: 10.1111/jch.14214
Popis: Data suggest that renal denervation (RDN) in treatment-resistant hypertension (TRHT) is safe in terms of renal function. However, most studies report kidney function as creatinine-based estimated glomerular filtration rate (eGFR), which may be biased by non-renal factors. Damage markers other than albuminuria have never been evaluated after RDN. In this non-randomized RDN trial, we studied changes in kidney function, assessed as measured GFR (mGFR) and various GFR estimates, six months and two years after RDN. We also examined changes in albuminuria and a biomarker of tubular dysfunction. Adult non-diabetic patients with TRHT and eGFR ≥45 ml/min/1.73 m2 were recruited from hypertension clinics. Before bilateral RDN, mGFR was measured by iohexol clearance. We estimated eGFR from serum creatinine and cystatin C (eGFRcrea, eGFRcys, and eGFRcreacys), and albumin-creatinine ratio (ACR) and N-acetyl-β-D-glucosaminidase (NAG)-creatinine ratio (NAG-CR) were measured in spot urines. All measurements were repeated after six and twenty-four months. Twenty patients, mean age 54 (±9) years and baseline mGFR 83 (±20) ml/min/1.73 m2 underwent RDN. After six months, mGFR fell, eGFRcrea remained unchanged, whereas eGFRcys and eGFRcreacys increased. At 2 years’ follow-up, eGFRcreacys was significantly lower than at baseline. mGFR was 78 (±28) ml/min/1.73 m2. Change in ambulatory systolic BP predicted change in eGFRcrea. Urinary NAG-CR, but not ACR, increased during follow-up. Different GFR assessments gave diverging results after RDN. Therefore, care should be taken to method when evaluating kidney function after RDN. Increases in a tubular dysfunction biomarker suggest that kidney damage may occur. Long-term renal follow-up is needed after RDN.
Databáze: OpenAIRE
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