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

被引:5
作者
Yang, Xiangyu [1 ]
Lin, Lede [2 ]
Zhang, Zhipeng [1 ]
Chen, Xiaoping [1 ]
机构
[1] Sichuan Univ, West China Hosp, Dept Cardiol, Chengdu 610041, Peoples R China
[2] Sichuan Univ, West China Hosp, Dept Urol, Chengdu, Peoples R China
基金
中国国家自然科学基金;
关键词
catecholamines; electrolytes; Raas; renal denervation; sympathetic nervous system; SYMPATHETIC DENERVATION; BLOOD-PRESSURE; RESISTANT HYPERTENSION; UNCONTROLLED HYPERTENSION; NERVE ABLATION; PREVALENCE; TRANSPORT; RESPONSES; PLASMA; INDEX;
D O I
10.1111/jch.14590
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
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.
引用
收藏
页码:1537 / 1546
页数:10
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