Blood pressure and renal outcomes after renal denervation in patients with chronic kidney disease
Jahanzeb Malik, Sidra Baig, Muhammad Subhan, F.N.U. Sandesh, Pooja Kumari, Abida PerveenBackground:
This systematic review and meta-analysis aimed to evaluate the efficacy and safety of renal denervation (RDN) in patients with chronic kidney disease (CKD), including those with end-stage renal disease requiring dialysis and resistant hypertension.
Methods:
A comprehensive search of PubMed, Embase, Scopus, and Cochrane databases was performed from inception to August 2025. Eligible studies included randomized trials, non-randomized clinical trials, and prospective observational cohorts enrolling adult CKD patients undergoing RDN. The primary outcomes were changes in office and 24-hour ambulatory blood pressure (BP). Secondary outcomes included changes in estimated glomerular filtration rate and safety endpoints. Data were synthesized using random-effects meta-analysis, with heterogeneity assessed by
Results:
Twelve studies involving 202 patients with CKD stages 2 to 5, including dialysis populations, were analyzed. Pooled results demonstrated significant reductions in office systolic BP (−20 mm Hg) and diastolic BP (−8 mm Hg), as well as ambulatory systolic (−15 mm Hg) and diastolic BP (−6 mm Hg). Renal function remained stable, with no evidence of accelerated decline in estimated glomerular filtration rate. Safety analysis revealed a low incidence of complications, limited to isolated access-site events, with no excess risk of renal artery stenosis. Heterogeneity was moderate (
Conclusion:
RDN effectively lowers BP in CKD patients without compromising renal function and demonstrates an acceptable safety profile, supporting its role as an adjunctive therapy in resistant hypertension.