Radiofrequency Ablation for ADPKD Blood Pressure and Disease Progression Control (RAFALE)
Autosomal Dominant Polycystic Kidney Disease, Hypertension
About this trial
This is an interventional treatment trial for Autosomal Dominant Polycystic Kidney Disease focused on measuring hypertension, radiofrequency ablation, autosomal dominant polycystic kidney disease
Eligibility Criteria
Inclusion Criteria:
- Patients with ADPKD.
- Having hypertension, defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg, and currently using 2 antihypertensive drugs and receiving a stable antihypertensive treatment regimen without change in dose or medication in the previous 30 days.
- Male and female patients 20 years to 60 years of age.
- Glomerular Filtration Rate (GFR) ≥30 ml/min/1.73 m2, estimated from serum creatinine using the Chronic Kidney Disease Epidemiology collaboration(CKD-EPI) equation.
- Have followed-up kidney and cyst volume at least 6 months in Shanghai Changzheng Hospital.
- Signed Informed Consent after being informed.
Exclusion Criteria:
- Documented renal vascular disease.
- Congenital absence of a kidney.
- Systemic illness with renal involvement.
- Spot urine albumin-to-creatinine ratio of >0.5 g/g and/or findings suggestive of kidney disease other than ADPKD.
- Exclusions specific to MRI acquisition and measurement: cardiac pacemaker, presence of MRI incompatible metallic clips or other material, excessive body weight, untreatable claustrophobia.
- Contraindications to the catheter-based renal denervation procedure by RFA, including allergy to radioiodinated contrast agents. Anatomical abnormalities of the renal arteries which preclude RFA: presence in either kidneys of multiple main renal arteries, main renal artery stenosis >50%, or main renal arteries of <4 mm in diameter or <20 mm in length.
- Contraindications on ethical grounds.
- Women who are pregnant or breast feeding.
- Intention to become pregnant during the course of the study.
- Lack of safe contraception: Female subjects of childbearing potential, not using and not willing to continue using a medically reliable method of contraception for the entire study duration, such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices, or who are not using any other method considered sufficiently reliable by the investigator in individual cases (Female subjects who are surgically sterilized/hysterectomized or post-menopausal for longer than 2 years are not considered as being of child bearing potential).
- Other clinically significant concomitant disease states (hepatic dysfunction, cardiovascular disease, metastatic cancer).
- Known or suspected non-compliance, drug or alcohol abuse.
- Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia or confusional state of the subject.
- Participation in another study with investigational drug within the 30 days preceding and during the present study.
- Previous enrolment into the current study.
- Enrolment of the investigator, his/her family members, employees and other dependent persons.
Sites / Locations
- Department of Nephrology, Shanghai Changzheng HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
renal sympathetic denervation
antihypertensive drugs
One-time standard bilateral renal sympathetic denervation by catheter-based radiofrequency ablation and using antihypertensive drugs which at least include an angiotensin converting enzyme inhibitor (ACE-I) or an angiotensin II receptor blocker (ARB).
Blood pressure control in ADPKD patients with hypertension only using antihypertensive drugs which at least include an angiotensin converting enzyme inhibitor (ACE-I) or an angiotensin II receptor blocker (ARB)