Improvement of albuminuria after renal denervation

Int J Cardiol. 2014 May 1;173(2):311-5. doi: 10.1016/j.ijcard.2014.03.017. Epub 2014 Mar 15.


Objectives: The primary objective of this study was the effect of renal denervation (RDN) on elevated urinary albumin-to-creatinine ratio (UACR) in treatment-resistant hypertensive patients. In addition, patients were stratified according their UACR at baseline into micro- (30-300 mg/g, n=37) and macroalbuminuria (≥ 300 mg/g, <2,200 mg/g, n=22).

Background: Increased albuminuria indicates cardiovascular and renal damage in hypertension. RDN emerged as an innovative interventional approach to reduce blood pressure (BP) and may thus reduce albumin urinary excretion.

Methods: Fifty-nine treatment-resistant hypertensive patients with elevated UACR at baseline underwent catheter-based RDN using the Symplicity Flex™ catheter (Medtronic Inc., Santa Rosa, CA).

Results: In the whole and pre-specified subgroups both office and 24-h ambulatory BP were significantly reduced 6 months after RDN. In parallel, a significant reduction in UACR occurred in all patients (160 (65-496) versus 89 (29-319) mg/g creatinine, p<0.001) and in both subgroups (microalbuminuria: 83 (49-153) versus 58 (17-113) mg/g creatinine, p=0.001; macroalbuminuria: (536 (434-1483) versus 478 (109-1080) mg/g creatinine, p<0.001). In accordance, the prevalence of micro- and macroalbuminuria decreased significantly. Regression analysis revealed a modest positive relationship between the decrease of UACR and the fall of systolic BP (β=0.340, p=0.039) independent of renal function. Renal function remained unchanged after RDN.

Conclusions: In summary, following RDN, the magnitude of albuminuria as well as the prevalence of micro- and macroalbuminuria decreased in treatment-resistant hypertensive patients. Since albuminuria is an independent renal and cardiovascular risk factor, our findings suggest a reduction of renal and cardiovascular risk in these patients.

Trial registration: NCT01687725.

Keywords: Albuminuria; Blood pressure; Renal denervation; Renal organ damage; Treatment resistant hypertension; Urinary albumin-to-creatinine ratio.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Albuminuria / complications
  • Albuminuria / metabolism*
  • Albuminuria / surgery*
  • Blood Pressure
  • Catheter Ablation
  • Creatinine / urine
  • Female
  • Heart Rate
  • Humans
  • Hypertension / complications
  • Hypertension / metabolism*
  • Hypertension / surgery*
  • Kidney / innervation*
  • Kidney / physiology
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Prognosis
  • Sympathectomy / methods*


  • Creatinine

Associated data