Sustained Decrease in Blood Pressure and Reduced Anatomical and Functional Reinnervation of Renal Nerves in Hypertensive Sheep 30 Months After Catheter-Based Renal Denervation

Reetu R. Singh, Zoe M. McArdle, Michael Iudica, Lawrence K. Easton, Lindsea C. Booth, Clive N. May, Helena C. Parkington, Paul Lombardo, Geoff A. Head, Gavin Lambert, Karen M. Moritz, Markus P. Schlaich, Kate M. Denton

Research output: Contribution to journalArticleResearchpeer-review

Abstract

We examined whether renal denervation (RDN) reduced blood pressure (BP), improved glomerular filtration rate, albuminuria, and left ventricular mass in sheep with hypertensive chronic kidney disease (CKD). To examine whether renal nerve function returned in the long term, we examined vascular contraction to nerve stimulation in renal arteries and determined nerve regrowth by assessing renal TH (tyrosine hydroxylase), CGRP (calcitonin gene-related peptide), and norepinephrine levels in kidneys at 30 months after RDN. RDN normalized BP in hypertensive CKD sheep such that BP was similar to that of the normotensive sheep with intact nerves. Glomerular filtration rate decreased by ≈22% in CKD sheep with intact nerves but increased ≈26% in hypertensive CKD-RDN sheep by 30 months. At 30 months, urinary albumin was ≈127% and left ventricular mass was ≈41% greater in CKD sheep with intact nerves than control. However, urinary albumin was ≈60% less and left ventricular mass was ≈40% less in the CKD sheep that underwent RDN compared with intact counterpart. At 30 months in CKD-RDN sheep, neurovascular contraction (≈56%), renal proportion of TH (≈50%), CGRP (≈67%), and norepinephrine content (≈49%) were all less than CKD-intact; all these variables were similar between normotensive-intact and normotensive-RDN groups. RDN caused a sustained reduction in BP and improvements in renal function. Regrowth of renal nerves and return of function were observed in hypertensive CKD-RDN sheep, but levels were only partially restored to levels of intact. These suggest that RDN lowers BP in the long term and is renoprotective and cardioprotective as a result of lesser nerve regrowth in CKD.

Original languageEnglish
Pages (from-to)718-727
Number of pages10
JournalHypertension
Volume73
Issue number3
DOIs
Publication statusPublished - 1 Mar 2019

Keywords

  • animals
  • hemorrhage
  • hypertension
  • renal insufficiency, chronic
  • sheep

Cite this

Singh, Reetu R. ; McArdle, Zoe M. ; Iudica, Michael ; Easton, Lawrence K. ; Booth, Lindsea C. ; May, Clive N. ; Parkington, Helena C. ; Lombardo, Paul ; Head, Geoff A. ; Lambert, Gavin ; Moritz, Karen M. ; Schlaich, Markus P. ; Denton, Kate M. / Sustained Decrease in Blood Pressure and Reduced Anatomical and Functional Reinnervation of Renal Nerves in Hypertensive Sheep 30 Months After Catheter-Based Renal Denervation. In: Hypertension. 2019 ; Vol. 73, No. 3. pp. 718-727.
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title = "Sustained Decrease in Blood Pressure and Reduced Anatomical and Functional Reinnervation of Renal Nerves in Hypertensive Sheep 30 Months After Catheter-Based Renal Denervation",
abstract = "We examined whether renal denervation (RDN) reduced blood pressure (BP), improved glomerular filtration rate, albuminuria, and left ventricular mass in sheep with hypertensive chronic kidney disease (CKD). To examine whether renal nerve function returned in the long term, we examined vascular contraction to nerve stimulation in renal arteries and determined nerve regrowth by assessing renal TH (tyrosine hydroxylase), CGRP (calcitonin gene-related peptide), and norepinephrine levels in kidneys at 30 months after RDN. RDN normalized BP in hypertensive CKD sheep such that BP was similar to that of the normotensive sheep with intact nerves. Glomerular filtration rate decreased by ≈22{\%} in CKD sheep with intact nerves but increased ≈26{\%} in hypertensive CKD-RDN sheep by 30 months. At 30 months, urinary albumin was ≈127{\%} and left ventricular mass was ≈41{\%} greater in CKD sheep with intact nerves than control. However, urinary albumin was ≈60{\%} less and left ventricular mass was ≈40{\%} less in the CKD sheep that underwent RDN compared with intact counterpart. At 30 months in CKD-RDN sheep, neurovascular contraction (≈56{\%}), renal proportion of TH (≈50{\%}), CGRP (≈67{\%}), and norepinephrine content (≈49{\%}) were all less than CKD-intact; all these variables were similar between normotensive-intact and normotensive-RDN groups. RDN caused a sustained reduction in BP and improvements in renal function. Regrowth of renal nerves and return of function were observed in hypertensive CKD-RDN sheep, but levels were only partially restored to levels of intact. These suggest that RDN lowers BP in the long term and is renoprotective and cardioprotective as a result of lesser nerve regrowth in CKD.",
keywords = "animals, hemorrhage, hypertension, renal insufficiency, chronic, sheep",
author = "Singh, {Reetu R.} and McArdle, {Zoe M.} and Michael Iudica and Easton, {Lawrence K.} and Booth, {Lindsea C.} and May, {Clive N.} and Parkington, {Helena C.} and Paul Lombardo and Head, {Geoff A.} and Gavin Lambert and Moritz, {Karen M.} and Schlaich, {Markus P.} and Denton, {Kate M.}",
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Sustained Decrease in Blood Pressure and Reduced Anatomical and Functional Reinnervation of Renal Nerves in Hypertensive Sheep 30 Months After Catheter-Based Renal Denervation. / Singh, Reetu R.; McArdle, Zoe M.; Iudica, Michael; Easton, Lawrence K.; Booth, Lindsea C.; May, Clive N.; Parkington, Helena C.; Lombardo, Paul; Head, Geoff A.; Lambert, Gavin; Moritz, Karen M.; Schlaich, Markus P.; Denton, Kate M.

In: Hypertension, Vol. 73, No. 3, 01.03.2019, p. 718-727.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Sustained Decrease in Blood Pressure and Reduced Anatomical and Functional Reinnervation of Renal Nerves in Hypertensive Sheep 30 Months After Catheter-Based Renal Denervation

AU - Singh, Reetu R.

AU - McArdle, Zoe M.

AU - Iudica, Michael

AU - Easton, Lawrence K.

AU - Booth, Lindsea C.

AU - May, Clive N.

AU - Parkington, Helena C.

AU - Lombardo, Paul

AU - Head, Geoff A.

AU - Lambert, Gavin

AU - Moritz, Karen M.

AU - Schlaich, Markus P.

AU - Denton, Kate M.

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