Impact of renal denervation on urinary peptides: a prospective, single-arm, single-centre study

Background: Catheter-based renal denervation (RDN) reduces blood pressure (BP) in hypertension. Urinary peptides are associated with cardiovascular and renal diseases and provide prognostic information. The impact of RDN on the urinary peptidome remains elusive.
Objective: To investigate the effect of RDN on urinary peptide-based biomarker panels associated with chronic kidney disease and heart disease and to identify urinary peptides affected by RDN.
Methods: This study included patients undergoing bilateral catheter-based radiofrequency RDN for the treatment of hypertension. Urine samples were collected before and 48 months after RDN and were analysed using capillary electrophoresis coupled with mass spectrometry. Predefined urinary peptide-based biomarker panels for chronic kidney disease (CKD273), coronary artery disease (CAD238), and heart failure (HF1) were applied.
Results: A total of 48 patients (33% female) underwent RDN. Systolic (165±17 mmHg vs 148±20 mmHg; p<0.0001) and diastolic blood pressure (90±17 mmHg vs 81±13 mmHg; p<0.0001), as well as mean arterial pressure (115±15 mmHg vs 103±13 mmHg; p<0.0001) decreased significantly between baseline and 48 months after RDN. A total of 103 urinary peptides from 37 different proteins, mostly collagens, were identified as being altered following RDN. CAD238, a 238 coronary artery-specific polypeptides pattern, significantly improved following RDN (Cohen’s d -0.632; p=0.0001; Figure) whereas the classification scores HF1 (p=0.8295) and CKD273 (p=0.6293) did not change.
Conclusion: RDN beneficially affected urinary peptides associated with coronary artery disease.