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Effects of catheter‐based renal denervation on renin‐aldosterone system, catecholamines, and electrolytes: A systematic review and meta‐analysis

In recent years, catheter‐based renal denervation (RDN) has emerged as a promising instrumental therapy for hypertension. The interruption of sympathetic nervous system was regarded as a possible mechanism for RDN regulating blood pressure. While the results reflected by renin‐angiotensin‐aldosteron...

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Autores principales: Yang, Xiangyu, Lin, Lede, Zhang, Zhipeng, Chen, Xiaoping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9731592/
https://www.ncbi.nlm.nih.gov/pubmed/36321724
http://dx.doi.org/10.1111/jch.14590
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author Yang, Xiangyu
Lin, Lede
Zhang, Zhipeng
Chen, Xiaoping
author_facet Yang, Xiangyu
Lin, Lede
Zhang, Zhipeng
Chen, Xiaoping
author_sort Yang, Xiangyu
collection PubMed
description In recent years, catheter‐based renal denervation (RDN) has emerged as a promising instrumental therapy for hypertension. The interruption of sympathetic nervous system was regarded as a possible mechanism for RDN regulating blood pressure. While the results reflected by renin‐angiotensin‐aldosterone system (RAAS), catecholamines and electrolytes remained inconsistent and was never systematically assessed. Pubmed, Embase, and Web of Science were comprehensively searched from inception to September 5, 2021. Studies that evaluated the effects of RDN on RAAS, catecholamines, and electrolytes were identified. Primary outcomes were changes in RAAS hormones after RDN, and secondary outcomes involved changes in plasma norepinephrine, serum, and urinary sodium and potassium. Out of 6391 retrieved studies, 20 studies (two randomized controlled studies and 18 observational studies) involving 771 persons were eventually included. Plasma renin activity had a statistically significant reduction after RDN (0.24 ng/mL/h, 95% CI 0.04 to 0.44, P = .02). While no significant change was found regarding plasma aldosterone (1.53 ng/dL, 95% CI ‐0.61 to 3.67, P = .16), norepinephrine (0.42 nmol/L, 95% ‐0.51 to 1.35, P = 0.38), serum sodium and potassium (0.16 mmol/L, 95% CI ‐0.17 to 0.49, P = .34; ‐0.02 mmol/L, 95% CI ‐0.09 to 0.04, P = .48, respectively), and urinary sodium and potassium (3.95 mmol/24 h, 95% CI ‐29.36 to 37.26, P = .82; 10.22 mmol/24 h, 95% CI ‐12.11 to 32.54, P = .37, respectively). In conclusion, plasma renin activity significantly decreased after RDN, while no significant change was observed in plasma aldosterone, plasma norepinephrine, and serum and urinary electrolytes.
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spelling pubmed-97315922022-12-12 Effects of catheter‐based renal denervation on renin‐aldosterone system, catecholamines, and electrolytes: A systematic review and meta‐analysis Yang, Xiangyu Lin, Lede Zhang, Zhipeng Chen, Xiaoping J Clin Hypertens (Greenwich) Systematic Review and Meta‐analysis In recent years, catheter‐based renal denervation (RDN) has emerged as a promising instrumental therapy for hypertension. The interruption of sympathetic nervous system was regarded as a possible mechanism for RDN regulating blood pressure. While the results reflected by renin‐angiotensin‐aldosterone system (RAAS), catecholamines and electrolytes remained inconsistent and was never systematically assessed. Pubmed, Embase, and Web of Science were comprehensively searched from inception to September 5, 2021. Studies that evaluated the effects of RDN on RAAS, catecholamines, and electrolytes were identified. Primary outcomes were changes in RAAS hormones after RDN, and secondary outcomes involved changes in plasma norepinephrine, serum, and urinary sodium and potassium. Out of 6391 retrieved studies, 20 studies (two randomized controlled studies and 18 observational studies) involving 771 persons were eventually included. Plasma renin activity had a statistically significant reduction after RDN (0.24 ng/mL/h, 95% CI 0.04 to 0.44, P = .02). While no significant change was found regarding plasma aldosterone (1.53 ng/dL, 95% CI ‐0.61 to 3.67, P = .16), norepinephrine (0.42 nmol/L, 95% ‐0.51 to 1.35, P = 0.38), serum sodium and potassium (0.16 mmol/L, 95% CI ‐0.17 to 0.49, P = .34; ‐0.02 mmol/L, 95% CI ‐0.09 to 0.04, P = .48, respectively), and urinary sodium and potassium (3.95 mmol/24 h, 95% CI ‐29.36 to 37.26, P = .82; 10.22 mmol/24 h, 95% CI ‐12.11 to 32.54, P = .37, respectively). In conclusion, plasma renin activity significantly decreased after RDN, while no significant change was observed in plasma aldosterone, plasma norepinephrine, and serum and urinary electrolytes. John Wiley and Sons Inc. 2022-11-02 /pmc/articles/PMC9731592/ /pubmed/36321724 http://dx.doi.org/10.1111/jch.14590 Text en © 2022 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Systematic Review and Meta‐analysis
Yang, Xiangyu
Lin, Lede
Zhang, Zhipeng
Chen, Xiaoping
Effects of catheter‐based renal denervation on renin‐aldosterone system, catecholamines, and electrolytes: A systematic review and meta‐analysis
title Effects of catheter‐based renal denervation on renin‐aldosterone system, catecholamines, and electrolytes: A systematic review and meta‐analysis
title_full Effects of catheter‐based renal denervation on renin‐aldosterone system, catecholamines, and electrolytes: A systematic review and meta‐analysis
title_fullStr Effects of catheter‐based renal denervation on renin‐aldosterone system, catecholamines, and electrolytes: A systematic review and meta‐analysis
title_full_unstemmed Effects of catheter‐based renal denervation on renin‐aldosterone system, catecholamines, and electrolytes: A systematic review and meta‐analysis
title_short Effects of catheter‐based renal denervation on renin‐aldosterone system, catecholamines, and electrolytes: A systematic review and meta‐analysis
title_sort effects of catheter‐based renal denervation on renin‐aldosterone system, catecholamines, and electrolytes: a systematic review and meta‐analysis
topic Systematic Review and Meta‐analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9731592/
https://www.ncbi.nlm.nih.gov/pubmed/36321724
http://dx.doi.org/10.1111/jch.14590
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