A recent study has found that a special treatment called radiofrequency renal denervation (RDN) can help lower blood pressure in people with difficult-to-treat high blood pressure, including those who have chronic kidney disease (CKD).
The results were published online in the journal Hypertension and offer hope to patients who haven’t responded well to other treatments.
The study was led by Dr. Markus P. Schlaich from the University of Western Australia.
His team wanted to see if RDN could help people with uncontrolled high blood pressure, and whether it would also be safe and effective for those with moderate to severe kidney problems.
RDN is a procedure that uses radio waves to target nerves in the kidneys that play a role in raising blood pressure. By calming these nerves, the treatment helps reduce blood pressure without the need for more medication.
The researchers followed 3,291 patients who had RDN and grouped them based on how well their kidneys were working. They used a measurement called eGFR to divide the patients into three categories: those with healthy kidneys (eGFR ≥60), those with moderate kidney problems (eGFR 45 to 59), and those w…
At the start of the study, all three groups had similar high levels of systolic blood pressure, the top number in a blood pressure reading. After three years, people in all groups had lower blood pressure.
The group with healthy kidneys saw an average drop of 17.2 mmHg, those with moderate kidney issues had a 12.1 mmHg drop, and the group with more severe kidney disease had a 13.0 mmHg drop. These reductions are considered meaningful and can help lower the risk of heart disease and stroke.
Importantly, the treatment did not appear to harm kidney function. Over one year, there was a slight decline in kidney function in the healthy kidney group, but not in the groups that already had kidney disease. This is a positive sign that the treatment may be safe for people with CKD.
The study also looked at death rates over three years. In people without kidney disease, the death rate was 4.3%. It was 7.0% in those with moderate kidney disease and 15.2% in those with more serious kidney issues.
While these numbers reflect the increasing health risks of CKD, the treatment itself did not seem to cause major kidney problems. In fact, adverse kidney events occurred in less than 1% of patients in all groups.
Another interesting finding was how the treatment affected the need for blood pressure medication. In people with more serious kidney problems, the need for medication actually went down over the three-year period.
This suggests that RDN may help reduce dependence on drugs, which is good news for people who experience side effects from their medications.
Overall, the researchers concluded that RDN may be a safe and useful option for people with moderate-to-severe CKD who still have high blood pressure despite other treatments.
However, they also noted that more research is needed, especially since the study was funded by Medtronic, a medical device company that may have an interest in the results.
Still, the findings are promising. For patients struggling with both kidney disease and high blood pressure, RDN might offer a new path to better health and a lower risk of heart problems.
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The study is published in Hypertension.
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