Effects of Renal Denervation Documented in the Austrian National Multicentre Renal Denervation Registry

Abstract

Renal denervation (RDN) is a new procedure for treatment-resistant hypertensive patients. In order to monitor all procedures undergone in Austria, the Austrian Society of Hypertension established the investigator-initiated Austrian Transcatheter Renal Denervation (TREND) Registry. From April 2011 to September 2014, 407 procedures in 14 Austrian centres were recorded. At baseline, office and mean 24-h ambulatory blood pressure (ABP) were 171/94 and 151/89 mmHg, respectively, and patients were taking a median of 4 antihypertensive medications. Mean 24-h ABP changes after 2–6 weeks, 3, 6 and 12 months were -11/-6, -8/-4, -8/-5 and -10/-6 mmHg (p<0.05 at all measurements), respectively. The periprocedural complication rate was 2.5%. Incidence of long-term complications during follow-up (median 1 year) was 0.5%. Office BP and ABP responses showed only a weak correlation (Pearson coefficient 0.303). Based on the data from the TREND registry, ambulatory blood pressure monitoring in addition to office BP should be used for patient selection as well as for monitoring response to RDN. Furthermore, criteria for optimal patient selection are suggested.

Erythrocyte Salt Sedimentation Assay Does Not Predict Response to Renal Denervation

“…In this single center analysis, a considerable proportion of patients benefited from RDN. As also shown in other trials particularly patients with the high baseline BP are more likely to respond ( 16 ). The responder rate of 64.7% in this analysis and the overall BP reduction of −17/−7 mmHg in office BP and −8/−6 mmHg in 24 h mean BP accordingly, was comparable to other RDN trials ( 16 – 19 ).…”

“…As also shown in other trials particularly patients with the high baseline BP are more likely to respond ( 16 ). The responder rate of 64.7% in this analysis and the overall BP reduction of −17/−7 mmHg in office BP and −8/−6 mmHg in 24 h mean BP accordingly, was comparable to other RDN trials ( 16 – 19 ). In the recently published Austrian Transcatheter National Multicentre Renal Denervation (TREND) Registry, Zweiker and colleagues found very similar results in their 188 RDN patients treated in 14 centers.…”

“…In the recently published Austrian Transcatheter National Multicentre Renal Denervation (TREND) Registry, Zweiker and colleagues found very similar results in their 188 RDN patients treated in 14 centers. A reduction of −20/−7 mmHg in office BP and −8/−5 mmHg in 24 h mean BP was described ( 16 ). The large Global Symplicity Registry that includes the German GREAT Registry showed in their set of 998 patients treated in 134 centers a reduction of −12 mmHg in office BP 6 months after RDN (ABPM reduction −7 mmHg) ( 13 ).…”

Catheter-based renal denervation in hypertension

“…These data are in line with positive results of major registries [7], for example, from the United Kingdom [8], Austria [9], and Greece [10]. Such observational data are key to appreciate the efficacy and safety of real-world patients undergoing RDN outside of controlled clinical studies.…”

New data, new studies, new hopes for renal denervation in patients with uncontrolled hypertension

“…Fig. 1 c shows average office BP reduction from baseline in 9 registries, mostly in Europe but also from around the world [ [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] ]. These registries included in total 2265 patients with drug resistant hypertension.…”