Chen Xiao, Meng Jie, Zhou Qiufeng, Ni Yuehua, Zuo Changyang, Zhang Yanfang
Department of Neurosurgery, Suzhou Ninth People's Hospital, Suzhou, Jiangsu, China.
Department of Neurology, Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China.
J Clin Hypertens (Greenwich). 2025 Jun;27(6):e70080. doi: 10.1111/jch.70080.
This meta-analysis evaluates the efficacy and safety of renal denervation (RDN) for patients with hypertension. PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov were systematically searched to identify relevant studies published before December 31, 2024. Review Manager 5.3 software was used to assess the results of the meta-analyses and the risk of bias plot. We pooled 2208 participants from 13 studies. The RDN was superior to the sham surgery group in the change in 24 h ambulatory systolic blood pressure (ASBP) and the change in 24 h ambulatory diastolic blood pressure (ADBP) (MD: -4.55 mmHg, 95% CI: -5.65 to -3.44; MD: -2.37 mmHg, 95% CI: -3.06 to -1.68, respectively). For the change in daytime ASBP and ADBP, significant differences were found between the RDN group and the sham group (MD: -6.21 mmHg, 95% CI: -7.61 to -4.80; MD: -2.96, 95% CI: -3.85 to -2.07). Compared to the sham surgery group, the RDN group showed better results in the change in night-time ASBP and ADBP (MD: -4.67 mmHg, 95% CI: -6.32 to -3.03; MD: -2.28 mmHg, 95% CI: -3.33 to -1.24). No significant differences were found between the RDN group and the sham group in terms of adverse events (AEs) and serious adverse events (SAEs) (p = 0.39 and 0.07). Subgroup analyses showed that RDN remains effective at long-term follow-up, and both ultrasound and radiofrequency RDN were effective. Current evidence shows that RDN is an effective treatment for patients with hypertension and does not increase the risk of AEs and SAEs.
本荟萃分析评估了肾去神经支配术（RDN）治疗高血压患者的疗效和安全性。系统检索了PubMed、EMBASE、Cochrane图书馆和ClinicalTrials.gov，以识别2024年12月31日前发表的相关研究。使用Review Manager 5.3软件评估荟萃分析结果和偏倚风险图。我们汇总了来自13项研究的2208名参与者。RDN在24小时动态收缩压（ASBP）变化和24小时动态舒张压（ADBP）变化方面优于假手术组（MD：-4.55 mmHg，95%CI：-5.65至-3.44；MD：-2.37 mmHg，95%CI：-3.06至-1.68）。对于日间ASBP和ADBP的变化，RDN组与假手术组之间存在显著差异（MD：-6.21 mmHg，95%CI：-7.61至-4.80；MD：-2.96，95%CI：-3.85至-2.07）。与假手术组相比，RDN组在夜间ASBP和ADBP变化方面显示出更好的结果（MD：-4.67 mmHg，95%CI：-6.32至-3.03；MD：-2.28 mmHg，95%CI：-3.33至-1.24）。RDN组与假手术组在不良事件（AE）和严重不良事件（SAE）方面未发现显著差异（p = 0.39和0.07）。亚组分析表明，RDN在长期随访中仍然有效，超声和射频RDN均有效。目前的证据表明，RDN是治疗高血压患者的有效方法，且不会增加AE和SAE的风险。
