Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(2):246-250 | DOI: 10.5507/bp.2015.030

Effect of renal denervation on glucose metabolism after a 12 month follow-up

Daniel Matousa, Otakar Jiravskya, Igor Nykla, Marian Brannya
a AGEL Research and Training Institue - Trinec Branch, Cardiovascular Centre, Podlesi Hospital, Trinec, Czech Republic

Background: Renal denervation is an invasive endovascular procedure using radiofrequency ablation of the renal arteries. This reduces renal sympathetic activity. However, the effect of renal denervation on glucose metabolism remains unclear.

Aim: To evaluate the relation between sympathetic activity and glucose metabolism.

Methods: We enrolled 51 patients with resistant hypertension who underwent renal denervation in our hospital from September 2011 to July 2013. We divided the patients into 4 subgroups: those with diabetes mellitus; those without diabetes mellitus; patients who had undergone bilateral denervation with at least 4 radiofrequency applications to each renal artery. The last subgroup of patients had fewer than 4 applications bilaterally or only unilateral application for anatomical or technical reasons. For all patients the Simplicity flex catheter (Medtronic) was used. Fasting glucose, glycated hemoglobin, albuminuria and C-peptide were measured before the procedure and after 12 months.

Results: In all patients (n = 51) fasting glucose levels significantly increased (from 7.4± 2.0 mmol/L to 7.8±2.6 mmol/L; P = 0.032). Glycated hemoglobin increased slightly but not significantly (from 46.1±10.5 mmol/mol to 47.6±13.6 mmol/mol; P = 0.079). There were no significant changes in albuminuria (71.2±191.0 mg/L to 66.1±185.5 mg/L; P = 0.108) or C-peptide levels (1178±429 pmol/L to 1271±565 pmol/L; P = 0.098).

Conclusions: We found no effect of renal denervation on glucose metabolism after 12 months follow-up.

Keywords: renal denervation, glucose metabolism, diabetes mellitus, sympathetic activity, compliance

Received: December 17, 2014; Accepted: May 28, 2015; Prepublished online: June 11, 2015; Published: June 28, 2015  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Matous, D., Jiravsky, O., Nykl, I., & Branny, M. (2015). Effect of renal denervation on glucose metabolism after a 12 month follow-up. Biomedical papers159(2), 246-250. doi: 10.5507/bp.2015.030


Editorial Commentary, p. 338


Download citation

References

  1. Ganong WF. Review of Medical Physiology. 20th ed. New York: McGraw Hill; 2001. 
  2. Ferrannini E, Buzzigoli G, Bonadonna R, Giorico MA, Oleggini M, Graziadei L, Pedrinelli R, Brandi L, Bevilacqua S. Insulin resistance in essential hypertension. N Engl J Med 1987;317:350-7. Go to original source... Go to PubMed...
  3. Mancia G, Bousquet P, Elghozi JL, Esler M, Grassi G, Julius S, Reid J, Van Zwieten PA. The sympathetic nervous system and the metabolit syndrome. J Hypertens 2007;25:909-20. Go to original source... Go to PubMed...
  4. Masuo K, Mikami H, Ogihara T, Tuck ML. Sympathetic nerve hyperaktivity precedes hyperinsulinemia and blood pressure elevation in a young, nonobese Japanese population. Am J Hypertens 1997;10:77-83. Go to original source... Go to PubMed...
  5. Grassi G, Dell'Oro R, Quarti-Trevano F, Scopelliti F, Seravalle G, Paleari F, Gamba PL, Mancia G. Neuroadrenergic and reflex abnormalities in patients with metabolic syndrome. Diabetologia 2005;48:1359-65. Go to original source... Go to PubMed...
  6. Grassi G, Dell'Oro R, Facchini A, Quarti Trevano F, Bolla GB, Mancia G. Effect of central and peripheral body fat distribution on sympathetic and baroreflex function in obese normotensives. J Hypertens 2004;22:2363-9. Go to original source... Go to PubMed...
  7. Huggett RJ, Scott EM, Gilbey SG, Stoker JB, Mackintosh AF, Mary DA. Impact of type 2 diabetes mellitus on sympathetic neural mechanisms in hypertension. Circulation 2003;108:3097-101. Go to original source... Go to PubMed...
  8. Lembo G, Napoli R, Capaldo B, Rendina V, Iaccarino G, Volpe M, Trimarco B, Sacca L. Abnormal sympathetic overactivity evoked by insulin in the skeletal muscle of patients with essential hypertension. J Clin Invest 1992;90:24-9.  Go to original source... Go to PubMed...
  9. Scherrer U, Sartori C. Insulin as a vascular and sympathoexcitatory hormone: implications for blood pressure regulation, insulin sensitivity, and cardiovascular morbidity. Circulation 1997;96:4104-13. Go to original source... Go to PubMed...
  10. Bardgett ME, McCarthy JJ, Stocker SD. Glutamatergic receptor activation in the rostral ventrolateral medulla mediates the sympathoexcitatory response to hyperinsulinemia. Hypertension 2010;55:284-90. Go to original source... Go to PubMed...
  11. Mahfoud F, Schlaich M, Kindermann I, et al. Effect of renal sympathetic denervation on glucose metabolism in patients with resistant hypertension: a pilot study. Circulation 2011; 123:1940-6. Go to original source... Go to PubMed...
  12. International Expert Committee report on the role of the a1c assay in the diagnosis of diabetes. Diabetes Care 2009;32:1327-34. Go to original source... Go to PubMed...
  13. Cooper-DeHoff RM, Pacanowski MA, Pepine CJ. Cardiovascular therapies and associated glucose homeostasis: implications across the dysglycemia continuum. J Am Coll Cardiol 2009;53:28 -34. Go to original source... Go to PubMed...
  14. Guillausseau PJ. Influence of oral antidiabetic drugs compliance on metabolic control in type 2 diabetes. A survey in general practice. Diabetes Metab 2003;29(1):79-81. Go to original source... Go to PubMed...
  15. Jung O, Gechter JL, Wunder C, et al. Resistant hypertension? Assessment of adherence by toxicological urine analysis. J Hypertens 2013;31:766-74. Go to original source... Go to PubMed...
  16. Burnier M. Medication adherence and persistence as the cornerstone of effective antihypertensive therapy. Am J Hypertens 2006;19:1190-6. Go to original source... Go to PubMed...
  17. Bangalore S, Kamalakkannan G, Parkar S, Messerli FH. Fixed-dose combinations improve medication compliance: a meta-analysis. Am J Med 2007;120:713-9. Go to original source... Go to PubMed...
  18. Bhatt DL, Kandzari DE, O'Neill WW, D'Agostino R, Flack JM, Katzen BT, Leon MB, Liu M, Mauri L, Negoita M, Cohen SA, Oparil S, Rocha-Singh K, Townsend RR , Bakris GL. A Controlled Trial of Renal Denervation for Resistant Hypertension. N Engl J Med 2014; 370:1393-401. Go to original source... Go to PubMed...