13 December 2013

Kidney patient among first to receive pioneering treatment for high blood pressure

SPECIALISTS at Sheffield Teaching Hospitals NHS Foundation Trust have used a pioneering treatment to reduce high blood pressure in a kidney patient whose blood pressure could not be controlled with conventional medication.

Professor Peter Gaines, Dr William McKane and Martin BarnsleyMartin Barnsley, 64, of Barnsley, was first diagnosed with high blood pressure 26 years ago, and nothing could control it. This included taking eight different kinds of blood pressure lowering medicines a day to reduce his risk of life-threatening stroke, heart attack and kidney failure.

Now he is one of the first people in the world with a single kidney to benefit from an advanced type of renal denervation therapy, which is offered to certain patients with drug-resistant high blood pressure. Renal denervation therapy is where the nerves around the blood vessels leading into the kidneys are destroyed more precisely in a quicker procedure using radiofrequency energy that does not require surgery. The radiofrequency energy disrupts the network of nerves around the kidneys, causing blood pressure to drop significantly in most patients. In Martin's case, the reduction has been about 20% – a drop which is expected to improve further over the next year.

The treatment was carried out by Professor Peter Gaines, a consultant vascular radiologist at Sheffield's Northern General Hospital, as part of a five-year research study looking at how effectively the St Jude Medical EnligHTN Renal Denervation System can improve health and lower blood pressure in patients with impaired kidney function.

Around 200,000 people in the UK suffer with drug-resistant high blood pressure, and are 16 times more likely to have a stroke or heart attack than those with well controlled blood pressure.

Dr William McKane, a consultant kidney specialist at Sheffield Teaching Hospitals NHS Foundation Trust and principal investigator for the study, said: "We are delighted to have performed this revolutionary minimally invasive treatment, which has been shown to significantly reduce blood pressure in patients that are resistant to medication. This study gives us the chance to make the treatment available to patients with some loss of kidney function, including in this case a patient who has already had a kidney removed. This is not a cure for high blood pressure, but it offers some hope for appropriate patients where usual treatments have not been effective.

Blood pressure is controlled through radiofrequency energy which destroy the nerves around the blood vessels leading in and out of the kidneys"Drug-resistant hypertension is very hard to treat, and the heart has to work much harder in patients with uncontrolled high blood pressure. This puts patients at greater risk of life-threatening stroke, heart attack and kidney failure. Renal denervation offers a much needed new treatment option for patients where medications and lifestyle interventions have failed."

Professor Peter Gaines commented: "Since 1995 the Sheffield Vascular Institute has been combining the skills of surgeons with interventional radiologists to diagnose and treat blood vessel disorders. We have performed a number of landmark treatments so it's great news for patients that we are one of the few hospitals in the region currently offering this nerve-tingling treatment."

Martin Barnsley, a former deputy head who has now set up his own psychotherapy practice said, "I've suffered with high blood pressure for years, and they found I had a cancer in the right kidney after I was referred to heart specialists in 2010. Although surgery to remove the kidney cured the cancer, my blood pressure remained sky high. I then found out there was study taking place to help reduce high blood pressure and although I'm still taking a lot of medications, my blood pressure has dropped significantly. There was no pain whatsoever and it took an hour start to finish. I actually found it really relaxing, and as I was sedated and I even listened to some Bach.

"My blood pressure has significantly dropped, and treatments like this give you a lot of optimism. I feel really lucky and the care has been amazing."

Drug-resistant hypertension is defined as where the peak blood pressure is above 160 mmHg, despite patients taking three or more blood pressure lowering medication. Renal denervation is not routinely available on the NHS for treatment of high blood pressure, but NHS England recently announced plans to make it available in specialist centres for the most hard-to-treat cases.

The St Jude Medical EnligHTN Renal Denervation System uses an advanced generator to produce a predictable pattern of radiofrequency waves, which are passed into the arteries using a catheter inserted in a groin artery. The first use of EnligHTN in the UK took place at Sheffield Teaching Hospitals on 22 October 2012.

Martin had the treatment as part of the EnlighHTN II trial.

Further information can be found at http://www.nice.org.uk/nicemedia/live/13340/57923/57923.pdf

To further support the funding of extra research into kidney treatment,  contact Sheffield Hosptials Charity on 0114 271 1351 or email charity@shct.nhs.uk.


Claudia Blake, Research and Innovation Communications Officer
Tel: 0114 226 5033
Email: claudia.blake@sth.nhs.uk


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