Effect of extensive artery isolation during robotic-assisted partial nephrectomy on blood pressure of patients with poorly controlled hypertension: a preliminary study

• Published in: International urology and nephrology Vol. 55; no. 1; pp. 29 - 36
• Main Authors: Wang, Xin, Zhao, Xiaozhi, Ji, ChangWei, Liu, Guangxiang, Li, Xiaogong, Guo, Hongqian
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.01.2023; Springer Nature B.V
• Subjects: Antihypertensive Agents - pharmacology; Antihypertensive Agents - therapeutic use; Antihypertensives; Blood Pressure; Complications; Denervation; Humans; Hypertension; Hypertension - complications; Hypertension - drug therapy; Kidney cancer; Medicine; Medicine & Public Health; Nephrectomy; Nephrology; Postoperative; Renal artery; Renal Artery - surgery; Robotic surgery; Robotic Surgical Procedures; Treatment Outcome; Urology; Urology - Original Paper; Veins & arteries; Hypertension; Renal denervation; Sympathetic nerve; Kidney neoplasms
• ISSN: 1573-2584; 0301-1623; 1573-2584
• DOI: 10.1007/s11255-022-03384-1

Purpose To investigate whether extensive renal artery isolation during robotic-assisted partial nephrectomy (RAPN) for renal cell carcinoma (RCC) affects blood pressure (BP) of patients with poorly controlled hypertension. Methods We included 60 patients diagnosed with poorly controlled hypertension who underwent RAPN by an experienced surgeon. The renal artery of the treated kidney was sufficiently isolated. Systolic BP (SBP), diastolic BP (DBP) and antihypertensive medication information were obtained at baseline and 3- and 6-month follow-up after surgery. Primary endpoints were changes in BP, and medications. Predictors of SBP reduction at 3 months were assessed by multivariable logistic regression. Results All 60 RAPN procedures were successful, with no major intra- or postoperative complications. Mean SBP and DBP decreased significantly at 3 months after surgery (SBP, −7.8 ± 6.3 mmHg, P  < 0.001; DBP, −4.2 ± 6.4 mmHg, P  = 0.01). SBP and DBP did not differ between 3- and 6-month follow-up. The mean number of BP medications prescribed was lower at 3 months than baseline (1.7 ± 1.0 vs 2.1 ± 1.0, P  = 0.016). The only significant predictor of SBP reduction at 3 months was baseline SBP. Conclusions Renal denervation with extensive renal artery isolation during RAPN may improve BP control among patients with poorly controlled hypertension in short term.