resistant hypertension and renal dysfunction
Conditions
Interventions
Non-haemodialysis group:Renal denervation
Haemodialysis group:Renal denervation
Sponsors
The West China Hospital of Sichuan University
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: a. Individuals were 18 years of age or older and =160 mmHg, based on an average of three readings at the initial and confirmatory screening visits. d. Estimated 30<=eGFR<=40 patients not undergoing BP dialysis or undergoing hemodialysis. e. Individuals agree to perform all study procedures and are able and willing to provide written informed consent to participate in this clinical study.
Exclusion criteria
Exclusion criteria: 1) Unsuitable renal artery anatomy includes :a. major renal arteries 50%) or renal artery aneurysm. d. Previous renal artery intervention, including balloon angioplasty or stent placement. e. Unilateral kidney. 2) patients have been hospitalized for hypertensive crisis at least once in the past year. Hypertensive crisis: Severely elevated (BP) blood pressure, usually above 180/110 mmhg, with progressive or impending target organ damage, requiring hospitalization, usually admission to an intensive care unit (ICU)(e.g., with parenteral (IV) antihypertensive agents), independent of confirmed medication nonadherence. 3) patients with 24-hour mean systolic blood pressure =1 episode of orthostatic hypotension (systolic BP decrease >=20 mmHg or diastolic BP decrease >=10 mmHg within 3 minutes of standing) with symptoms unrelated to medication changes within the past year or during screening. 6) In addition to nocturnal respiratory support, patients with sleep apnea require long-term oxygen support or mechanical ventilation (e.g., tracheotomy, CPAP, BiPAP). 7) individuals with primary pulmonary hypertension. 8) patients have known factors for secondary hypertension such as pheochromocytoma, Cushing's disease, coarctation of the aorta, untreated hyperthyroidism, or primary hyperparathyroidism. 9) myocardial infarction, unstable angina, syncope, or cerebrovascular accident, or extensive atherosclerosis with intravascular thrombosis or unstable plaque within 3 months of the screening period. 10) patients had scheduled or planned surgery or cardiovascular intervention within the next 6 months. 11) have conditions that prohibit or interfere with accurate BP measurement with the protocol-specified automated BP monitor (e.g., an arm diameter that is too large for measurement with a cuff; Arrhythmias interfere with the automated monitor's pulse sensing, preventing accurate measurements). 12) had severe valvular stenosis, and significant blood pressure lowering was considered by the investigators to be contraindicated. 13) the individual has any serious medical condition that the investigator believes may adversely affect the safety and/or efficacy of the participant or the study (e.g., patients with clinically significant peripheral vascular disease, abdominal aortic aneurysm, bleeding disorders such as thrombocytopenia, hemophilia, or significant anemia). 14) being pregnant, breastfeeding, or planning to become pregnant. Female participants of childbearing potential had to have a negative serum or urinary human chorionic gonadotropin (hCG) pregnancy test before angiography. 15) patients have a known, unresolved history of substance use or alcohol dependence, lack the ability to understand or follow instructions, or are unlikely or unable to comply with study follow-up requirements. 16) has participated in other clinical studies. 17) patients with a history of organ transplantation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Office Blood Pressure;Urinary albumin creatinine ratio;urine microalbumin;Blood catecholamines and their metabolites;Physiological fluctuation of cortisol;Recumbent position test; | — |
Secondary
| Measure | Time frame |
|---|---|
| 24-hour ambulatory blood pressure monitoring;urine sodium;C-reactive protein;ferritin;interleukin-6;interleukin-1;Serum amyloid A;ESR; | — |
Countries
China
Contacts
Public ContactYong Peng
The West China Hospital of Sichuan University
Outcome results
None listed