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.

AGEL Research and Training Institue Trinec Branch Cardiovascular Centre Podlesi Hospital Trinec Czech Republic

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Editorial Commentary, p. 338