The present study aims to evaluate the clinical outcomes following renal denervation (RDN) for hypertensive patients with chronic kidney disease (CKD). Prospective studies published between January 1, 2010 and November 15, 2022 where systematically identified for RDN outcomes on office and ambulatory blood pressure, estimated glomerular filtration rate (eGFR), creatinine and procedural characteristics from three online databases (Medline, PubMed, EMBASE). Random effects model to combine risk ratios and mean differences was used. Where possible, clinical outcomes were pooled and analyzed at 6, 12 and 24 months. Significance was set at p ≤ 0.05. 11 prospective trials, with a total of 226 patients with treatment resistant HTN receiving RDN met the inclusion criteria. Age ranged from 42.5 ± 13.8 to 66 ± 9. Main findings of this review included a reduction in systolic and diastolic office blood pressure at 6 [−19.8 (p < 0.00001)/−15.2 mm Hg (p < 0.00001)] and 12 months [−21.2 (p < 0.00001)/−9.86 mm Hg (p < 0.0005)] follow-up compared to baseline. This was also seen in systolic and diastolic 24-hour ambulatory blood pressure at 6 [−9.77 (p = 0.05)/−3.64 mm Hg (p = 0.09)] and 12 months [−13.42 (p = 0.0007)/−6.30 mm Hg (p = 0.001)] follow-up compared to baseline. The reduction in systolic and diastolic 24-hour ambulatory blood pressure was maintained to 24 months [(−16.30 (p = 0.0002)/−6.84 mm Hg (p = 0.0010)]. Analysis of kidney function through eGFR demonstrated non-significant results at 6 (+1.60 mL/min/1.73 m², p = 0.55), 12 (+5.27 mL/min/1.73 m², p = 0.17), and 24 months (+7.19 mL/min/1.73 m², p = 0.36) suggesting an interruption in natural CKD progression. Similar results were seen in analysis of serum creatinine at 6 (+0.120 mg/dL, p = 0.41), 12 (+0.100 mg/dL, p = 0.70), and 24 months (+0.07 mg/dL, p = 0.88). Assessment of procedural complications deemed RDN in a CKD cohort to be safe with an overall complication rate of 4.86%. With the current advances in RDN and its utility in multiple chronic diseases beyond hypertension, the current study summarizes critical findings that further substantiate the literature regarding the potential of such an intervention to be incorporated as an effective treatment for resistant hypertension and CKD.

本研究旨在评估患有慢性肾病（CKD）的高血压患者去肾神经支配（RDN）后的临床结果。2010 年 1 月 1 日至 2022 年 11 月 15 日期间发表的前瞻性研究，从三个在线数据库（Medline、PubMed、EMBASE）中系统地确定了 RDN 在诊室血压和动态血压、估计肾小球滤过率 (eGFR)、肌酐和程序特征方面的结果。使用结合风险比和平均差的随机效应模型。在可能的情况下，在 6、12 和 24 个月时汇总并分析临床结果。显着性设置为p  ≤ 0.05。11 项前瞻性试验，共有 226 名接受 RDN 治疗的耐药性 HTN 患者符合纳入标准。年龄范围为 42.5 ± 13.8 至 66 ± 9。本次评价的主要发现包括 6 [−19.8 ( p  < 0.00001)/−15.2 mm Hg ( p  < 0.00001)] 和 12 个月时的收缩压和舒张压降低 与基线相比，随访[−21.2 ( p  < 0.00001)/−9.86 mm Hg ( p < 0.0005)]。这在 6 [−9.77 ( p  = 0.05)/−3.64 mm Hg ( p  = 0.09)] 和 12 个月 [−13.42 ( p  = 0.0007)/−6.30 mm时的收缩压和舒张压 24 小时动态血压中也可见到。Hg ( p  = 0.001)] 与基线相比的随访。收缩压和舒张压 24 小时动态血压的降低维持了 24 个月 [(−16.30 ( p  = 0.0002)/−6.84 mm Hg ( p  = 0.0010)]。通过 eGFR 对肾功能进行的分析表明，在6（+1.60 mL/min/1.73 m ²，p  = 0.55）、12（+5.27 mL/min/1.73 m ²，p  = 0.17）和 24 个月（+7.19 mL/min/1.73 m ²，p  = 0.36）表明自然 CKD 进展中断。在 6 个月（+0.120 mg/dL，p  = 0.41）、12 个月（+0.100 mg/dL，p  = 0.70）和 24 个月（ +0.07 mg/dL，p  = 0.88)。手术并发症评估认为 CKD 队列中的 RDN 是安全的，总体并发症率为 4.86%。随着 RDN 目前的进展及其在高血压以外的多种慢性疾病中的应用，目前的研究总结了重要的发现，进一步证实了有关这种干预措施作为顽固性高血压和 CKD 的有效治疗方法的潜力的文献。