Renal denervation in multiple renal arteries

Area of Science:

• Cardiovascular medicine
• Interventional nephrology
• Hypertension management

Background:

• Previous renal denervation (RDN) studies often excluded patients with multiple renal arteries.
• The prevalence and impact of multiple renal arteries on RDN outcomes remain under-investigated.

Purpose of the Study:

• Determine the prevalence of multiple renal arteries in patients considered for RDN.
• Propose a classification for anatomical eligibility in RDN.
• Investigate the relationship between multiple renal arteries and the blood pressure-lowering effect of RDN.

Main Methods:

• Analysis of patients referred for RDN with pre-treatment noninvasive renal artery imaging.
• Inclusion of eligible patients who underwent RDN.
• Evaluation of renal function and blood pressure (BP) at 6 months post-treatment.

Main Results:

• 34% of 126 patients referred for RDN had multiple renal arteries.
• RDN significantly reduced office BP (195/106 to 165/95 mmHg, P < 0.001).
• BP reduction was comparable in patients with multiple arteries (all treated) versus solitary arteries; a trend towards less effect was seen if not all multiple arteries were treated (P=0.11).

Conclusions:

• Patients with multiple renal arteries should not be excluded from RDN due to their high prevalence.
• Incomplete treatment of multiple renal arteries may lead to a less pronounced blood pressure reduction.
• Renal function remained stable post-RDN across subgroups.