SaO003REAL WORLD EXPERIENCE OF RENAL DENERVATION: THE UK RENAL DENERVATION AFFILIATION REPORT

Abstract

Introduction and Aims: Renal denervation (RDN) may lower blood pressure (BP) in people with resistant hypertension. Here we report the combined UK experience of RDN. Methods: The UK Renal Denervation Affiliation is an independent investigator-led initiative of 16 centres, each had done >5 cases. A standardized dataset was collected retrospectively, anonymised and submitted to the coordinating centre for analysis. Results: 246 cases from 16 centres are reported. The average number of cases per centre was 15. Five different ablation technologies were used; unipolar catheters in 198 and multipolar in 48. The mean age was 56.7 years, 53% female, 87% Caucasian, and diabetes 27%. 24% percent patients had previous stroke, 15% myocardial infarction, and 26% had proteinuria. Patients were selected in accordance with the Joint UK Societies Consensus Statement 2012, by multi-disciplinary teams; 86% attended specialist hypertension clinics. On average 4.7 drugs were used before RDN; 95% were on ≥3drugs; 90% RAS blockers and diuretics, and 56% aldosterone antagonists. Pre-RDN mean office BP was 186/102 mmHg. Ambulatory blood pressure monitoring (ABPM) data were available for 179 patients (73%). Average day ABP was 170/98; night ABP was 154/86. Average follow-up was 10.7 months. Mean office BP post-RDN was 164/93, a fall of 22/9 mmHg (P<0.001). In 24% office systolic BP fell ≥ 40 mmHg. Average post-RDN day ABP was 158/92 and night ABP 145/81; fall in day ABP of 12/6 (p<0.001). 18% had a drop in day systolic ABP ≥ 20mmHg; 9% had a fall of ≥30mmHg. A decrease in GFR of ≥25% was seen at 10 month in 5% patients. There were no significant complications. Conclusions: In 246 patients, who had RDN in 16 UK centres there was a significant improvement in BP control with 22/9 mmHg reduction in office BP and 12/6 in day ABP. This suggests that carefully selected patients with resistant hypertension, with few remaining medical options, do have a significant BP reduction following RDN.