Among patients with resistant hypertension, it is very important to select patients most likely to benefit from renal sympathetic denervation, because they represent a very mixed group of diagnoses.
Prior to diagnosing a patient as having resistant hypertension, it is important to document adherence and exclude white-coat hypertension, inaccurate measurements of blood pressure and secondary causes of hypertension.
Renal sympathetic denervation has been demonstrated as an antihypertensive treatment in resistant hypertension patients with additional positive effects on glucose metabolism and insulin sensitivity in type 2 diabetes.
We report a single centre report of renal sympathetic denervation effects in a small cohort of patients with resistant hypertension and stage 2-3 chronic kidney disease.
Blood pressure reduction after renal sympathetic denervation was sustained at consecutive follow-up visits one, three and six months when compared to the baseline: office systolic blood pressure was significantly lower (144 ± 13, 140 ± 17, 141 ± 15 mmHg, p<0.001).
Randomized clinical trials are required to assess the impact of the reported changes.
Key words: resistant hypertension, stepwise screening protocol, renal denervation