Effects of catheter‐based renal denervation on renin‐aldosterone system, catecholamines, and electrolytes: A systematic review and meta‐analysis

Autor: Xiangyu Yang, Lede Lin, Zhipeng Zhang, Xiaoping Chen
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: The Journal of Clinical Hypertension, Vol 24, Iss 12, Pp 1537-1546 (2022)
Druh dokumentu: article
ISSN: 1751-7176
1524-6175
DOI: 10.1111/jch.14590
Popis: Abstract In recent years, catheter‐based renal denervation (RDN) has emerged as a promising instrumental therapy for hypertension. The interruption of sympathetic nervous system was regarded as a possible mechanism for RDN regulating blood pressure. While the results reflected by renin‐angiotensin‐aldosterone system (RAAS), catecholamines and electrolytes remained inconsistent and was never systematically assessed. Pubmed, Embase, and Web of Science were comprehensively searched from inception to September 5, 2021. Studies that evaluated the effects of RDN on RAAS, catecholamines, and electrolytes were identified. Primary outcomes were changes in RAAS hormones after RDN, and secondary outcomes involved changes in plasma norepinephrine, serum, and urinary sodium and potassium. Out of 6391 retrieved studies, 20 studies (two randomized controlled studies and 18 observational studies) involving 771 persons were eventually included. Plasma renin activity had a statistically significant reduction after RDN (0.24 ng/mL/h, 95% CI 0.04 to 0.44, P = .02). While no significant change was found regarding plasma aldosterone (1.53 ng/dL, 95% CI ‐0.61 to 3.67, P = .16), norepinephrine (0.42 nmol/L, 95% ‐0.51 to 1.35, P = 0.38), serum sodium and potassium (0.16 mmol/L, 95% CI ‐0.17 to 0.49, P = .34; ‐0.02 mmol/L, 95% CI ‐0.09 to 0.04, P = .48, respectively), and urinary sodium and potassium (3.95 mmol/24 h, 95% CI ‐29.36 to 37.26, P = .82; 10.22 mmol/24 h, 95% CI ‐12.11 to 32.54, P = .37, respectively). In conclusion, plasma renin activity significantly decreased after RDN, while no significant change was observed in plasma aldosterone, plasma norepinephrine, and serum and urinary electrolytes.
Databáze: Directory of Open Access Journals
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