TY - JOUR
T1 - Renal safety of catheter-based renal denervation
T2 - systematic review and meta-analysis
AU - Sanders, Margreet F.
AU - Reitsma, Johannes B.
AU - Morpey, Moira
AU - Gremmels, Hendrik
AU - Bots, Michiel L.
AU - Pisano, Anna
AU - Bolignano, Davide
AU - Zoccali, Carmine
AU - Blankestijn, Peter J.
N1 - Funding Information:
P.J.B. reports research grants from Medtronic and Saint Jude and acts as a consultant for Medtronic and Saint Jude outside the submitted work. M.L.B. reports research grants from Medtronic outside the submitted work. M.F.S., J.B.R., M.M., H.G., A.P., D.B., and C.Z. have nothing to declare. The results presented in this article have not been published previously in whole or part.
Funding Information:
M.F.S. is supported by a grant from the Dutch Kidney Foundation, project number CPI12.02.
Publisher Copyright:
© 2017 The Author.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background: Catheter-based renal denervation (RDN) is a possible treatment to lower blood pressure. The invasive nature of RDN and the use of contrast agents raise concerns about potential consequent kidney damage. Our objective was to determine the change in renal function after RDN by performing a systematic review on hypertensive patients treated with RDN.Methods: A systematic search was performed in the Embase and MEDLINE databases to identify studies reporting on the effects of catheter-based RDN on renal outcome. Studies published between January 2009 and May 2016, irrespective of study design, device used or indication for treatment were included. We performed random effects meta-analyses on the change in estimated glomerular filtration rate (eGFR), serum creatinine, serum cystatin C and albumin:creatinine ratio after RDN. We only extracted and meta-analysed data from patients treated with RDN.Results: From 1034 citations, 52 studies (38 cohort studies, 4 non-randomized comparative studies and 10 randomized controlled trials) reporting on 56 RDN cohorts were included in meta-analyses and another 14 studies in a qualitative review. Of these 56 cohorts, 48 were specifically eligible for determining the change in eGFR after RDN, totaling 2381 patients. There was no statistically significant change in eGFR after a mean follow-up time of 9.1 ± 7.0 months [0.64 mL/min/1.73 m 2 (95% confidence interval -0.47 to 1.76), P = 0.26]. The pooled mean change in serum creatinine and the results of the qualitative review further supported these findings.Conclusions: Based on meta-analyses of 52 studies and a qualitative review of an additional 14 studies, reporting on 2898 patients in total, we conclude that renal function does not significantly change up to at least 9 months after RDN.
AB - Background: Catheter-based renal denervation (RDN) is a possible treatment to lower blood pressure. The invasive nature of RDN and the use of contrast agents raise concerns about potential consequent kidney damage. Our objective was to determine the change in renal function after RDN by performing a systematic review on hypertensive patients treated with RDN.Methods: A systematic search was performed in the Embase and MEDLINE databases to identify studies reporting on the effects of catheter-based RDN on renal outcome. Studies published between January 2009 and May 2016, irrespective of study design, device used or indication for treatment were included. We performed random effects meta-analyses on the change in estimated glomerular filtration rate (eGFR), serum creatinine, serum cystatin C and albumin:creatinine ratio after RDN. We only extracted and meta-analysed data from patients treated with RDN.Results: From 1034 citations, 52 studies (38 cohort studies, 4 non-randomized comparative studies and 10 randomized controlled trials) reporting on 56 RDN cohorts were included in meta-analyses and another 14 studies in a qualitative review. Of these 56 cohorts, 48 were specifically eligible for determining the change in eGFR after RDN, totaling 2381 patients. There was no statistically significant change in eGFR after a mean follow-up time of 9.1 ± 7.0 months [0.64 mL/min/1.73 m 2 (95% confidence interval -0.47 to 1.76), P = 0.26]. The pooled mean change in serum creatinine and the results of the qualitative review further supported these findings.Conclusions: Based on meta-analyses of 52 studies and a qualitative review of an additional 14 studies, reporting on 2898 patients in total, we conclude that renal function does not significantly change up to at least 9 months after RDN.
KW - Hypertension
KW - meta-analysis
KW - renal denervation
KW - renal function
KW - safety
UR - https://www.scopus.com/pages/publications/85029802041
U2 - 10.1093/ndt/gfx088
DO - 10.1093/ndt/gfx088
M3 - Review article
C2 - 29059396
AN - SCOPUS:85029802041
SN - 0931-0509
VL - 32
SP - 1440
EP - 1447
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
IS - 9
ER -