Renal denervation in dialysis patients: long-term outcomes in a real-world setting

Resistant hypertension is common in patients with end-stage kidney disease (ESKD) who are on dialysis. Experience with percutaneous renal denervation (RDN) in these patients is limited and generally has short follow-up periods, primarily focusing on blood pressure (BP) control. In particular, the effects of RDN on anaemia, chronic kidney disease-mineral and bone disorder (CKD-MBD) and dialysis tolerance remain unexamined.

We report our experience with RDN in 14 dialysis patients [7 on haemodialysis (HD) and 7 on peritoneal dialysis (PD)] with a follow-up after RDN of 3-84 months. Six patients received kidney transplantation during follow-up.

BP and the number of antihypertensive drugs decreased (P = .008 and P = .018, respectively). RDN was equally effective in both HD and PD. In nearly all transplanted patients, BP normalized and the number of antihypertensive drugs was reduced after kidney transplantation. RDN did not alter treatment schedules for HD or PD and no episodes of acute intradialytic hypotension were reported. Additionally, there were no significant changes in treatments for anaemia or CKD-MBD. Only one patient had an RDN procedural complication.

Our experience with RDN in dialysis patients suggests beneficial effects in both HD and PD. BP improved significantly, with no observed issues related to the typical clinical problems faced by these patients, such as anaemia, CKD-MBD and dialysis tolerance. Furthermore, in those patients who received a kidney transplant, we noted a further improvement in BP control.