The effect of renal denervation on kidney oxygenation as determined by BOLD MRI in patients with hypertension

E. E. Vink, A. Boer, W. L. Verloop, W. Spiering, M. Voskuil, E. Vonken, J. M. Hoogduin, T. Leiner, M. L. Bots, P. J. Blankestijn*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives: Renal denervation (RDN) is a promising therapy for resistant hypertension. RDN is assumed to decrease sympathetic activity. Consequently, RDN can potentially increase renal oxygenation. Blood oxygen level-dependent MRI (BOLD-MRI) provides a non-invasive tool to determine renal oxygenation in humans. The aim of the current study was to investigate the effect of RDN on renal oxygenation as determined by BOLD-MRI.

Methods: Patients with resistant hypertension or the inability to follow a stable drug regimen due to unacceptable side effects were included. BOLD-MRI was performed before and 12 months after RDN. Twenty-seven patients were imaged on 3 T and 19 on 1.5 T clinical MRI systems.

Results: Fifty-four patients were included, 46 patients (23 men, mean age 57 years) completed the study. Mean 24-h BP changed from 163(±20)/98(±14) mmHg to 154(±22)/92(±13) mmHg (p = 0.001 and p < 0.001). eGFR did not change after RDN [77(±18) vs. 79(±20) mL/min/1.73 m<sup>2</sup> <inf>;</inf>p = 0.13]. RDN did not affect renal oxygenation [1.5 T: cortical R2*: 12.5(±0.9) vs. 12.5(±0.9), p = 0.94; medullary R2*: 19.6(±1.7) vs. 19.3(1.4), p = 0.40; 3 T: cortical R2*: 18.1(±0.8) vs. 17.8(±1.2), p = 0.47; medullary R2*: 27.4(±1.9) vs. 26.7(±1.8), p = 0.19].

Conclusion: The current study shows that RDN does not lead to changes in renal oxygenation 1 year after RDN as determined by BOLD-MRI.

Key Points: • Renal denervation significantly decreased ambulatory blood pressure. • Renal denervation did not change renal oxygenation as determined by BOLD-MRI. • Absence of a change in renal oxygenation might be explained by autoregulation.

Original languageEnglish
Pages (from-to)1984-1992
Number of pages9
JournalEuropean Radiology
Volume25
Issue number7
DOIs
Publication statusPublished - 8 Jul 2015

Keywords

  • Blood oxygen level-dependent MRI
  • Hypertension
  • Kidneys
  • Renal denervation
  • Renal oxygenation

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