N. Y. Savelieva, L. Gapon, E. Mikova, A. Zherzhova
{"title":"射频肾去神经术后顽固性高血压患者肾脏排泄功能的三年随访","authors":"N. Y. Savelieva, L. Gapon, E. Mikova, A. Zherzhova","doi":"10.36485/1561-6274-2023-27-2-91-97","DOIUrl":null,"url":null,"abstract":"It is generally accepted that the true-resistant hypertension (RH) currently remains critical issue. At present there is some published evidence that catheter renal denervation prosedure showed effectiveness at randomized clinical trials. The assessment of renal function after the technique is crucial.THE AIM of the study was to estimate renal function after renal artery denervation procedure in patients with uncontrolled hypertension in 3 – years follow-up.PATIENTS AND METHODS. The diagnosis of RH was made in the absence of any evidence of secondary hypertension. 40 patients (20 male and и 20 female), aged 55,5± 7,2 years, with office systolic blood pressure (BP) 180 ±26,1 mm Hg, and diastolic BP 107,4±13,9 mm Hg were examined. Glomerular filtration rate (GFR, MDRD) and microalbuminuria level was determined by averaging all measurements performed during hospitalization. Ambulatory blood pressure monitoring (BPM) was performed in all patients.RESULTS. BPM has revealed the significant decrease of systolic daytime blood pressure (at baseline 161,1±16,9 mm Hg and at follow-up 155,4±20,8 mm Hg; р= 0,024) and decrease of diastolic daytime BP (at baseline 95,6 ±11,8 mmHg and at follow -up 90,2 ±12,4 mm Hg; р=0,002). During 3 -year of follow-up the serum creatinine level has increased at baseline 69,5±16,4 μmol/l and at follow-up 78,7±19,5 μmol/l; р<0,0001). The Glomerular filtration rate has scaled down (at baseline 98,2±18,7 ml/min and at follow-up 85,1±17,9 ml/min; р< 0,0001). The level of daily excretion of albumin has also decreased (at baseline 30,4 [14,6; 52,9] mg and at follow-up 14,1 [11,9; 42,4] mg correspondingly; р= 0,03) .CONCLUSION. Although BP profile changes have demonstrated the effectiveness of RDN, therefore the future investigation of exact patho-physiological significance of glomerular filtration level after the treatment of RH should be of provided.","PeriodicalId":19089,"journal":{"name":"Nephrology (Saint-Petersburg)","volume":"10 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Renal excretory function in patients with resistant arterial hypertension after radiofrequency kidney denervation at three-year follow-up\",\"authors\":\"N. Y. Savelieva, L. Gapon, E. Mikova, A. Zherzhova\",\"doi\":\"10.36485/1561-6274-2023-27-2-91-97\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"It is generally accepted that the true-resistant hypertension (RH) currently remains critical issue. At present there is some published evidence that catheter renal denervation prosedure showed effectiveness at randomized clinical trials. The assessment of renal function after the technique is crucial.THE AIM of the study was to estimate renal function after renal artery denervation procedure in patients with uncontrolled hypertension in 3 – years follow-up.PATIENTS AND METHODS. The diagnosis of RH was made in the absence of any evidence of secondary hypertension. 40 patients (20 male and и 20 female), aged 55,5± 7,2 years, with office systolic blood pressure (BP) 180 ±26,1 mm Hg, and diastolic BP 107,4±13,9 mm Hg were examined. Glomerular filtration rate (GFR, MDRD) and microalbuminuria level was determined by averaging all measurements performed during hospitalization. Ambulatory blood pressure monitoring (BPM) was performed in all patients.RESULTS. BPM has revealed the significant decrease of systolic daytime blood pressure (at baseline 161,1±16,9 mm Hg and at follow-up 155,4±20,8 mm Hg; р= 0,024) and decrease of diastolic daytime BP (at baseline 95,6 ±11,8 mmHg and at follow -up 90,2 ±12,4 mm Hg; р=0,002). During 3 -year of follow-up the serum creatinine level has increased at baseline 69,5±16,4 μmol/l and at follow-up 78,7±19,5 μmol/l; р<0,0001). The Glomerular filtration rate has scaled down (at baseline 98,2±18,7 ml/min and at follow-up 85,1±17,9 ml/min; р< 0,0001). The level of daily excretion of albumin has also decreased (at baseline 30,4 [14,6; 52,9] mg and at follow-up 14,1 [11,9; 42,4] mg correspondingly; р= 0,03) .CONCLUSION. Although BP profile changes have demonstrated the effectiveness of RDN, therefore the future investigation of exact patho-physiological significance of glomerular filtration level after the treatment of RH should be of provided.\",\"PeriodicalId\":19089,\"journal\":{\"name\":\"Nephrology (Saint-Petersburg)\",\"volume\":\"10 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-06-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nephrology (Saint-Petersburg)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.36485/1561-6274-2023-27-2-91-97\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nephrology (Saint-Petersburg)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36485/1561-6274-2023-27-2-91-97","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目前,人们普遍认为,真正的顽固性高血压(RH)仍然是一个关键问题。目前有一些已发表的证据表明,在随机临床试验中,导管肾去神经支配手术显示出有效性。术后肾功能的评估是至关重要的。该研究的目的是在3年随访中评估未控制的高血压患者肾动脉去神经支配手术后的肾功能。患者和方法。RH的诊断是在没有任何继发性高血压的证据。40例患者(男性20例,女性20例),年龄55(5±7,2)岁,正常收缩压(BP) 180±26,1 mm Hg,舒张压(BP) 107,4±13,9 mm Hg。肾小球滤过率(GFR, MDRD)和微量白蛋白尿水平通过平均住院期间的所有测量来确定。所有患者均行动态血压监测(BPM)。BPM显示白天收缩压显著降低(基线时为161,1±16,9 mm Hg,随访时为155,4±20,8 mm Hg;r = 0,024),舒张期白天血压降低(基线时95,6±11,8 mmHg,随访时90,2±12,4 mmHg;р= 0002)。在3年的随访中,血清肌酐水平在基线时为69,5±16.4 μmol/l,在随访时为78,7±19.5 μmol/l;р< 0,0001)。肾小球滤过率下降(基线时为98.2±18.7 ml/min,随访时为85.1±17.9 ml/min;р< 0,0001)。白蛋白的日排泄水平也有所下降(基线值30,4 [14,6;52,9] mg,随访时14,1 [11,9;42,4] mg;r = 0.03)。虽然血压谱的改变已经证明了RDN的有效性,但未来对RH治疗后肾小球滤过水平的确切病理生理意义的研究仍需进一步提供。
Renal excretory function in patients with resistant arterial hypertension after radiofrequency kidney denervation at three-year follow-up
It is generally accepted that the true-resistant hypertension (RH) currently remains critical issue. At present there is some published evidence that catheter renal denervation prosedure showed effectiveness at randomized clinical trials. The assessment of renal function after the technique is crucial.THE AIM of the study was to estimate renal function after renal artery denervation procedure in patients with uncontrolled hypertension in 3 – years follow-up.PATIENTS AND METHODS. The diagnosis of RH was made in the absence of any evidence of secondary hypertension. 40 patients (20 male and и 20 female), aged 55,5± 7,2 years, with office systolic blood pressure (BP) 180 ±26,1 mm Hg, and diastolic BP 107,4±13,9 mm Hg were examined. Glomerular filtration rate (GFR, MDRD) and microalbuminuria level was determined by averaging all measurements performed during hospitalization. Ambulatory blood pressure monitoring (BPM) was performed in all patients.RESULTS. BPM has revealed the significant decrease of systolic daytime blood pressure (at baseline 161,1±16,9 mm Hg and at follow-up 155,4±20,8 mm Hg; р= 0,024) and decrease of diastolic daytime BP (at baseline 95,6 ±11,8 mmHg and at follow -up 90,2 ±12,4 mm Hg; р=0,002). During 3 -year of follow-up the serum creatinine level has increased at baseline 69,5±16,4 μmol/l and at follow-up 78,7±19,5 μmol/l; р<0,0001). The Glomerular filtration rate has scaled down (at baseline 98,2±18,7 ml/min and at follow-up 85,1±17,9 ml/min; р< 0,0001). The level of daily excretion of albumin has also decreased (at baseline 30,4 [14,6; 52,9] mg and at follow-up 14,1 [11,9; 42,4] mg correspondingly; р= 0,03) .CONCLUSION. Although BP profile changes have demonstrated the effectiveness of RDN, therefore the future investigation of exact patho-physiological significance of glomerular filtration level after the treatment of RH should be of provided.