Kidney Week 2025 Annual Meeting-Hypertension and Cardiorenal Disease: Novel Mechanisms and Therapeutic Targets

Video Transcription

Video Summary

The transcript summarizes several conference presentations focused on hypertension and chronic kidney disease (CKD).<br /><br />First, investigators reported 12‑month results from the sham-controlled RDN‑CKD Study testing ultrasound renal denervation (Paradise system) in stage 3 CKD patients (eGFR 30–60), a group excluded from prior renal denervation trials. In 15 treated patients (including crossovers), office BP fell by about 12/7 mmHg and 24‑hour ambulatory BP by about 9/6.5 mmHg, with reductions sustained across daytime and nighttime measures. Kidney function (creatinine and eGFR) and antihypertensive medication burden were unchanged, and no cardiovascular or renal adverse events occurred. Questions addressed non-responders (~25%), possible relapse (uncommon), limited albuminuria data, and the small sample size due to COVID.<br /><br />Next, a SPRINT secondary analysis introduced an individualized “net benefit” framework to personalize intensive systolic BP targets (<120 vs <140) in CKD, combining predicted absolute benefits (death, cardiovascular events, cognitive outcomes) and harms (AKI, syncope, electrolyte issues) weighted by simulated patient preferences. Among ~2,012 CKD participants, nearly all were predicted to benefit from intensive control, including ~90% even under harm-averse assumptions; those with more advanced CKD had higher harms but larger overall benefit.<br /><br />A cross-sectional Irish survey (201 clinicians, 304 patients) assessed attitudes toward AI decision support in hypertension. Both groups were generally positive but emphasized privacy, bias, explainability, and keeping clinicians in control; trust favored clinician advice over AI when discordant. Education was seen as key to closing an understanding–confidence gap, especially given limited EHR infrastructure in Ireland.<br /><br />Additional talks included an exercise cardiac MRI/CPET pilot identifying distinct exercise-limitation phenotypes in CKD, a simple algorithm to stratify higher cardiovascular risk within CKM syndrome stage 2, and animal data suggesting dual SGLT1/2 inhibition may better reduce salt-sensitive hypertension and kidney injury than SGLT2 inhibition alone.

Asset Subtitle

Moderator(s): Eman Gohar, Ajay Kher

Presentation(s):

Self-Monitoring and Self-Management of Hypertension in US Veterans: A Randomized Controlled Trial - Dena Rifkin
Exosomes as Mediators of Cardiomyocyte Injury and Heart Failure in Experimental Glomerular Disease - Justina Ray
Sustained Blood Pressure Reduction Following Ultrasound Renal Denervation in Patients with CKD: 12-Month Follow-Up Data from the RDN-CKD Study - Dennis Kannenkeril
Individualized Net Benefit of Intensive Blood Pressure Lowering Among Persons with CKD in SPRINT - Alan Vera
Attitudes and Perception of Artificial Intelligence in Hypertension: Cross-Sectional Survey Among Patients and Clinicians - Luke Harris
Exercise Cardiac MRI and Cardiopulmonary Testing Reveal Distinct Exercise Phenotypes and Dynamic Cardiac Impairment in CKD: CRUISE-CKD Study - Mirela Dobre
Risk-Based Stratification Approach for Cardiovascular-Kidney-Metabolic Syndrome Stage 2 Using a Simple Algorithm - Bernhard Schmidt
Deletions of Npr1 in Nephron Tubule Cells Lead to Salt-Sensitive Hypertension and Kidney Dysfunction in Both Male and Female Mutant Mice - Kandasamy Neelamegam
Dual SGLT1/2 Inhibition Attenuates Salt-Sensitive Hypertension and Kidney Injury More Effectively than SGLT2 Inhibition - Olha Kravtsova

Note: Continuing education credits are not being offered for this session.

Meta Tag

Date 11/7/2025

Pathway 1 Hypertension and Cardiorenal Disorders

Session ID 519888

Keywords

hypertension

chronic kidney disease

renal denervation

ultrasound renal denervation

RDN-CKD Study

stage 3 CKD

ambulatory blood pressure monitoring

SPRINT trial

intensive systolic blood pressure target

net benefit framework

AI decision support in hypertension

dual SGLT1/2 inhibition