Renal denervation: A potential new treatment modality for polycystic ovary syndrome?

Markus P. Schlaich, Nora Straznicky, Mariee Grima, Carolina Ika-Sari, Tye Dawood, Felix Mahfoud, Elisabeth Lambert, Reena Chopra, Flora Socratous, Sarah Hennebry, Nina Eikelis, Michael Böhm, Henry Krum, Gavin Lambert, Murray D. Esler, Paul A. Sobotka

Research output: Contribution to journalArticle

130 Citations (Scopus)

Abstract

Objective: Polycystic ovary syndrome (PCOS) is associated with sympathetic nervous system activation, insulin resistance, and blood pressure elevation. Renal nerve ablation has been demonstrated to reduce sympathetic outflow and improve blood pressure control. Here we report on the effects of renal denervation on hemodynamic, metabolic, and renal parameters in two obese PCOS patients with hypertension. Methods: Sympathetic nerve activity was assessed at baseline using microneurography and norepinephrine spillover measurements. Insulin sensitivity was assessed by euglycemic hyperinsulinemic clamp. Measurements of cystatin-C, creatinine clearance, and urinary albumin-creatinine ratio were also obtained. All measurements were repeated 3 months after bilateral renal denervation achieved via percutaneous endovascular radiofrequency ablation. Results: Muscle sympathetic nerve activity and whole body norepinephrine spillover were substantially elevated at baseline in both patients by approximately 2.5-3-fold. Bilateral renal nerve ablation reduced both indices of sympathetic nerve activity. This was associated with moderate reductions in blood pressure and a substantial improvement in insulin sensitivity by approximately 17.5% in the absence of weight changes at 3-month follow-up. Glomerular hyperfiltration and urinary albumin excretion were also reduced. Conclusion: These findings corroborate the relevance of sympathetic activation in PCOS and suggest that renal denervation exerts beneficial effects not only on blood pressure control but also on insulin sensitivity, renal, and endocrine abnormalities characteristic of PCOS.

Original languageEnglish
Pages (from-to)991-996
Number of pages6
JournalJournal of Hypertension
Volume29
Issue number5
DOIs
Publication statusPublished - May 2011
Externally publishedYes

    Fingerprint

Cite this

Schlaich, M. P., Straznicky, N., Grima, M., Ika-Sari, C., Dawood, T., Mahfoud, F., ... Sobotka, P. A. (2011). Renal denervation: A potential new treatment modality for polycystic ovary syndrome? Journal of Hypertension, 29(5), 991-996. https://doi.org/10.1097/HJH.0b013e328344db3a