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Plasma renalase concentration before and after radiofrequency renal denervation in patients with resistant hypertension

Journal of Human Hypertension volume 30, pages 410–411 (2016)Cite this article

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Renalase is a catecholamine-metabolising enzyme produced by proximal tubular cells in kidney, which is supposed to be involved in blood pressure regulation. The aim of the study was to evaluate plasma renalase concentration after radiofrequency renal denervation in patients with resistant arterial hypertension. The results of the study tend to suggest that renal denervation leads to the temporary decrease of plasma renalase concentration in patients with arterial hypertension. Lower plasma renalase concentration seems to counteract the antihypertensive effect of renal denervation.

Renal artery catheter-based radiofrequency denervation (RDN) was introduced as an invasive approach to treat patients with resistant arterial hypertension (HTN) aiming to destroy both afferent and efferent renal sympathetic nerves.1, 2 After first very optimistic and highly successful clinical trials,3, 4 recent randomized controlled trial (SYMPLICITY HTN–3) failed to denote clinical benefit derived from RDN in terms of arterial blood pressure (BP) control in 6- and 12-month observation, which may be related with inadequately selected population, incomplete nerve destruction, short duration of follow-up, or most importantly, refractory and compensatory mechanisms.1, 2 Renalase is a flavoprotein expressed mainly in proximal tubular cells and secreted into urine and blood, where it degrades circulating catecholamines into aminochromes, concurrently lowering BP.5 Renalase secretion was documented to be largely dependent on the current level of catecholamines6 and triggered by activation of renal dopamine receptor type 5.7 We hypothesised that RDN could lead to termination of positive feedback loop between sympathetic tone and renalase production that could hinder the effects of the procedure. We thus aimed to perform a pilot study to measure plasma renalase concentration before and after RDN in subjects with resistant HTN.

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References

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Acknowledgements

Grant for scientific research in the field of cardio-nephrology funded by Adamed Group under the auspices of Polish Society of Cardiology. ‘Complex assessment of the risk factors of contrast-induced acute kidney injury following coronary interventions’.

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Author notes

  1. M T Wybraniec and B Czerwieńska: These authors contributed equally to this work.

  2. A Więcek and K Mizia-Stec: These senior authors contributed equally to this work.

Authors and Affiliations

  1. First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland

    M T Wybraniec, M Lelek & K Mizia-Stec

  2. Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland

    B Czerwieńska, M Adamczak & A Więcek

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  1. M T Wybraniec
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Correspondence to M T Wybraniec.

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Wybraniec, M., Czerwieńska, B., Lelek, M. et al. Plasma renalase concentration before and after radiofrequency renal denervation in patients with resistant hypertension. J Hum Hypertens 30, 410–411 (2016). https://doi.org/10.1038/jhh.2015.94

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