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    Interventional procedure overview of alcohol-mediated perivascular renal sympathetic denervation for resistant hypertension

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    Outcome measures

    The main outcomes included reduction in BP (ABPM and office BP), use of antihypertensive medications, renal function (such as eGFR and serum creatinine), major or serious adverse events, and device- or procedure-related, nonserious adverse events. The key measures used are detailed in the following paragraphs.

    Reduction in BP included ABPM and office BP at follow ups compared with baseline, or between arms. A reduction in mean 24-hour ambulatory systolic BP of at least 5 mmHg relative to baseline was considered a clinically meaningful response to RDN (Mahfoud 2015). A mean decrease in office BP of 10 mmHg for systolic BP compared with baseline was judged to be a clinically meaningful reduction (Persu 2014).

    eGFR was used to indicate the overall index of kidney function, with a normal eGFR usually greater than 90 ml/min/1.73m2 and different stages are detailed as follows:

    • 90 or above: possible kidney damage with normal kidney function

    • 60 to 89: kidney damage with mild loss of kidney function

    • 45 to 59: mild to moderate loss of kidney function

    • 30 to 44: moderate to severe loss of kidney function

    • 15 to 29: severe loss of kidney function

    • less than 15: kidney failure

    eGFR could also be shown as a percentage of normal, ranging from 100% (full function) to 0% (no function). It is noted that eGFR declines with age, even in people without kidney disease.

    MAEs included all-cause death, end-stage renal disease, significant embolic event resulting in end-organ damage or needing intervention, major vascular complications, major bleeding events, postprocedural renal artery stenosis (>60% diameter stenosis), hypertensive crisis, and symptomatic hypotension needing medication.