The Effect of Renal Denervation on Capillary Density in Patients With Uncontrolled Hypertension

Hypertension is related to the pathogenesis of microvascular dysfunction. Renal denervation is a guideline-endorsed intervention for the management of uncontrolled hypertension. However, the effect of renal denervation on skin capillary density, as assessed by nailfold capillaroscopy, is unknown.

Individuals with stage I/II uncontrolled hypertensions were enrolled and allocated to either undergo renal denervation or serve as controls. Nailfold capillaroscopy was performed at baseline and at 12 months. Furthermore, the albumin to creatinine ratio (ACR) and office/ambulatory blood pressure (BP) levels were monitored throughout the study.

A total of 45 individuals (28 renal denervation, 17 control) were enrolled in our study. No difference was found in baseline capillary density. At 12 months, all patients had controlled BP, while the denervation arm had a significantly greater number of capillaries, compared with control (90.9 ± 14.0 vs. 82.5 ± 10.6 capillaries/mm²; p = 0.036). However, the change from baseline capillary density was not significantly different between groups (4.6 ± 6.1 vs. 1.39 ± 8.8 capillaries/mm²; p = 0.150). Moreover, the change of ACR was not different between groups (-2.7 ± 13.8 vs. 0.46 ± 5.2; p = 0.365).

In patients with uncontrolled stage I/II hypertension, renal denervation may have a beneficial effect on skin capillary density.