The effect of renal denervation in an experimental model of chronic renal insufficiency, The REmnant kidney Denervation In Pigs study (REDIP study)

Lubanda, Jean-Claude; Chochola, M; Mlček, Mikuláš; Neužil, Petr; Jakóbisiak, Marek; Havránek, Štěpán; Kuchynková, Sylvie; Fingrová, Zdeňka; Huang, Kao-Hsuan Aimee; Linhart, Aleš

doi:10.1186/s12967-017-1319-0

Cited by 7 publications

(3 citation statements)

References 29 publications

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“…In this view, renal nerve ablation could be studied as an additive renoprotective tool in a well-defined subset of individuals with pathologically high blood pressure. The rationale for such an application would be corroborated by previous reports showing a positive impact of renal denervation on GFR and proteinuria in experimental models of renal failure (Lubanda et al, 2017).…”

Section: Future Scenarios Of Clinical Application Of Renal Nerve Ablamentioning

confidence: 69%

Renal nerve ablation for resistant hypertension: facts, fictions and future directions

Bolignano

Coppolino

2019

Reviews in Cardiovascular Medicine

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Hypertension remains a major public health problem and one of the most relevant causes of cardiovascular mortality and morbidity worldwide. Roughly 10% of hypertensive individuals are considered as "resistant" as they are not able to achieve and maintain optimal blood pressure values despite the concurrent use of 3 antihypertensive agents of different classes at optimal doses. As resistant hypertension conveys a higher risk of adverse outcomes, the search for effective treatments to properly manage this condition has progressively surged as a true health priority. The renal nerve plexus plays a central role in regulating arterial blood pressure and renal sympathetic overactivity is a major component in the development and progression of hypertension. On these premises, minimally-invasive catheter based devices for renal nerve ablation have been developed and tested as an alternative treatment for resistant hypertension, but clinical study results have been ambiguous. This review provides a historical perspective on the scientific evidence forming the foundation of renal never ablation from accrued clinical evidence to possible future applications, reaching a tentative conclusion that more research and clinical experience is needed to fully reveal limits and potential indications of this procedure.

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Section: Future Scenarios Of Clinical Application Of Renal Nerve Ablamentioning

confidence: 69%

Renal nerve ablation for resistant hypertension: facts, fictions and future directions

Bolignano

Coppolino

2019

Reviews in Cardiovascular Medicine

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“…Renal denervation in a swine model of chronic renal insufficiency produced by ischemia failed to attenuate overall kidney damage as assessed by histology, serum urea, and creatinine, but did result in a decrease in circulating aldosterone in the denervated group (Lubanda et al, 2017) highlighting the involvement of the sympathetic nerves in the reninaldosterone-angiotensin system in this model. However, there was more damage in the renal artery wall of the denervated group in comparison to the control group, which may complicate interpretation of the results.…”

Section: Chronic Kidney Disease and Nervesmentioning

confidence: 85%

Autonomic nerves and circadian control of renal function

Becker¹,

Zhang²,

Soliman³

et al. 2019

Autonomic Neuroscience

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Cardiovascular and renal physiology follow strong circadian rhythms. For instance, renal excretion of solutes and water is higher during the active period compared to the inactive period, and blood pressure peaks early in the beginning of the active period of both diurnal and nocturnal animals. The control of these rhythms is largely dependent on the expression of clock genes both in the central nervous system and within peripheral organs themselves. Although it is understood that the central and peripheral clocks interact and communicate, few studies have explored the specific mechanism by which various organ systems within the body are coordinated to control physiological processes. The renal sympathetic nervous innervation has long been known to have profound effects on renal function, and because the sympathetic nervous system follows strong circadian rhythms, it is likely that autonomic control of the kidney plays an integral role in modulating renal circadian function. This review highlights studies that provide insight into this interaction, discusses areas lacking clarity, and suggests the potential for future work to explore the role of renal autonomics in areas such as blood pressure control and chronic kidney disease.

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“…A lack of renoprotective effect of RDN was also reported in a porcine chronic renal insufficiency model induced by selective renal artery embolisation. 105 …”

Section: Introductionmentioning

confidence: 99%

Patient Selection for Renal Denervation in Hypertensive Patients: What Makes a Good Candidate?

Li¹,

Phillips²

2022

VHRM

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Renal denervation (RDN) as a therapeutic intervention in patients with hypertension has been intensively studied for over a decade, yet a critical question remains unanswered: what kind of patients are the ideal target population for RDN to achieve its maximum clinical benefit? We herein provide a review of current literature to answer questions related to patient selection to identify populations that will benefit most from RDN, drawing first from human studies but also important clues derived from preclinical animal models. Different aspects that may influence the selection of patients such as the cause of hypertension, the severity of hypertension, concurrent pharmaceutical treatment, renal function, and renal artery anatomy are discussed. Based on current evidence, patients who have severe primary hypertension, regardless of medication or degree of renal dysfunction, who have an accessible accessory renal artery, can achieve a desirable response if a thorough ablation is achieved. In preclinical models, as in humans, RDN shows variable impact, with evidence indicating it does not work in specific conditions such as reduced renal mass, salt-sensitive hypertension, and autosomal recessive polycystic kidney disease. The thresholds, however, for indicators are such that it is still not possible to reliably predict which patients could benefit from the technique. Confirmation of predictive factors and identification of biomarkers are needed before RDN can be integrated in clinical practice on clear and reliable grounds.

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The effect of renal denervation in an experimental model of chronic renal insufficiency, The REmnant kidney Denervation In Pigs study (REDIP study)

Cited by 7 publications

References 29 publications

Renal nerve ablation for resistant hypertension: facts, fictions and future directions

Renal nerve ablation for resistant hypertension: facts, fictions and future directions

Autonomic nerves and circadian control of renal function

Patient Selection for Renal Denervation in Hypertensive Patients: What Makes a Good Candidate?

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