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Efficacy and safety of renal denervation for hypertension in patients with chronic kidney disease: a meta-analysis

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Item Type:Article
Title:Efficacy and safety of renal denervation for hypertension in patients with chronic kidney disease: a meta-analysis
Creators Name:Xia, M. and Liu, T. and Chen, D. and Huang, Y.
Abstract:BACKGROUND: Renal denervation (RDN) is a new treatment for hypertension in patients with chronic kidney disease (CKD), but its efficacy is still debated. This meta-analysis aimed to evaluate the efficacy and safety of RDN for hypertension in patients with CKD. METHODS: PubMed, Web of Science, EMBASE, and Ovid databases were searched for relevant studies published. We performed both fixed- and random-effects meta-analyses of the changes in blood pressure, estimated glomerular filtration rate (eGFR), and urinary albumin-to-creatinine ratio (UACR) after RDN. RESULTS: The meta-analysis included 238 patients from 11 single-center, non-randomized, uncontrolled studies. Office blood pressure and 24-hour ambulatory blood pressure (24 h-ABP) showed a significant reduction 1 month after RDN (p < 0.05). This decrease of 24 h-ABP persisted for 24 months after RDN showed difference systolic blood pressure (p < 0.001) and diastolic blood pressure (p = 0.001). The 24 h-ABP exhibited a similar trend in the subgroup analysis. eGFR measurements obtained at each time point of analysis after RDN were not significantly different from those obtained before (p > 0.05). UACR levels were significantly reduced at 3 months and 6 months after RDN (p < 0.001). After RDN, the heart rate showed no significant changes (p > 0.05), and few major complications were encountered. CONCLUSIONS: The meta-analysis showed that RDN may be effective and safe for treating CKD patients with hypertension. Well-designed randomized controlled trials of RDN are urgently needed to confirm the safety and reproducibility of RDN and to assess its impact on clinical outcomes.
Keywords:Renal Denervation, Hypertension, Chronic, Kidney Disease, End-Stage, Renal Disease, Meta-Analysis
Source:International Journal of Hyperthermia
Publisher:Taylor & Francis
Page Range:732-742
Official Publication:https://doi.org/10.1080/02656736.2021.1916100
PubMed:View item in PubMed

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