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Denervation of the REnal Artery in Metabolic Syndrome (DREAMS)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01465724
Recruitment Status : Completed
First Posted : November 6, 2011
Last Update Posted : December 30, 2014
Information provided by (Responsible Party):
Michiel Voskuil, MD, PhD, UMC Utrecht

Brief Summary:

The current prevalence of hypertension as part of the metabolic syndrome is substantial and is increasing with the rise of obesity worldwide. Chronic elevation of sympathetic nervous system (SNS) activity has been identified as a common and key factor in disease states as obesity-related hypertension (ORH). The renal sympathetic nerves are a major contributor to the complex pathophysiology of this elevated SNS activity. Percutaneous renal denervation (PRDN), the deliberate disruption of the nerves connecting the kidneys with the central nervous system, has been shown to be an effective means of modulating elevated SNS activity.

This current study is an observational feasibility study, with the aim to investigate the effect of renal denervation on changes in insulin resistance and blood pressure in patients with obesity related hypertension. The investigators will study different variables: a laboratorial set, a set of blood pressure measurements and a set of investigations in the vascular laboratory.


  • The investigators hypothesize that renal denervation has a beneficial effect on insulin resistance.
  • The investigators hypothesize that there will be no complications related to the device or procedure.

Condition or disease Intervention/treatment Phase
Insulin Resistance Blood Pressure Procedure: Renal denervation Phase 3

Detailed Description:

Objectives: The objectives of this study are: to compare changes in insulin resistance in patients with ORH after RDN; to evaluate the safety of PRDN in this patient group; to compare changes in blood pressure, laboratory parameters, arterial stiffness and SNS-activity after PRDN.

Study design: Prospective observational feasibility-study.

Study population: Patients with a high fasting glucose (fasting serum glucose ≥5.6 mmol/L(100 mg/dL)) and with an ambulatory systolic blood pressure >130mmHg.

Major endpoints: The effect of RDN on: insulin resistance, blood pressure and major adverse events.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 29 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Sympathetic Denervation of the Renal Artery for the Treatment of Obesity-related Hypertension and Insulin Resistance
Study Start Date : November 2011
Actual Primary Completion Date : September 2014
Actual Study Completion Date : September 2014

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Renal denervation Procedure: Renal denervation
percutaneous selective renal sympathetic denervation with the use of the Symplicity Catheter system.
Other Name: Symplicity Catheter system

Primary Outcome Measures :
  1. Difference in Insulin resistance before and 12 months after renal denervation [ Time Frame: T=0, T=6 months, and t=12 months ]
    To investigate the influence of percutaneous renal sympathetic denervation on insulin resistance. Hereby evaluating an Oral Glucose Tolerance Test before and after renal denervation

Secondary Outcome Measures :
  1. Difference in blood pressure before and after renal denervation [ Time Frame: t=0, t=6 months, and t=12 months ]
  2. Safety [ Time Frame: one year ]
    Major adverse events, characterized by myocardial infarction, cerebrovascular accident or all-cause mortality.

  3. Fasting glucose before and after renal denervation [ Time Frame: t=0 and t=12 months ]
  4. Change in Muscle sympathetic nerve activity (MSNA)after renal denervation [ Time Frame: t=0 and t=6 months ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients should have a high fasting glucose (fasting serum glucose ≥5.6 mmol/L (≥100 mg/dL)), without the use of antidiabetic drugs at the time of inclusion AND should have a 24 hour ambulatory SBP >130 mmHg, without the use of antihypertensive drugs at the time of inclusion.
  • Patients should fulfil one or more other criteria to meet the definition of the metabolic syndrome.
  • Individual understands the study procedures, alternative treatments available, risks involved with the study and voluntarily agrees to participate by giving informed consent.
  • Individual is over 18 years of age on the day of signing informed consent.

Exclusion Criteria:

  • SBP >180 mmHg and/or DBP >110 mmHg during one or more screening measurements.
  • 24-hour ambulatory SBP >170 mmHg and/or 24-hour ambulatory DBP >100 mmHg at time of inclusion.
  • Individual is treated with more than one type of antihypertensive medication at time of inclusion.
  • Individual is treated with more than one type of drug for diabetes mellitus 2 at time of inclusion and/or the medication for DM type 2 can not be stopped.
  • Individual has a treatable secondary cause of hypertension.
  • Individual has renal artery anatomy that is ineligible for treatment.
  • Individual has an estimated glomerular filtration rate (eGFR) of <45mL/min/1.73m2, using the MDRD calculation.
  • Individual has type 1 diabetes mellitus.
  • Individual has experienced a myocardial infarction, unstable angina pectoris, or a cerebrovascular accident within 6 months of the screening visit, or has widespread atherosclerosis, with documented intravascular thrombosis or unstable plaques.
  • Individual has scheduled or planned surgery or cardiovascular intervention in the next 6 months.
  • Individual has hemodynamically significant valvular heart disease for which reduction of BP would be considered hazardous.
  • Individual has an implantable cardioverter defibrillator (ICD) or pacemaker whose settings cannot allow for RF energy delivery.
  • Individual has any serious medical condition, which in the opinion of the investigator, may adversely affect the safety and/or effectiveness of the participant or the study (i.e., patients with clinically significant peripheral vascular disease, abdominal aortic aneurysm, bleeding disorders such as thrombocytopenia, haemophilia, or significant anaemia).
  • Individual is pregnant, nursing or planning to be pregnant.
  • Individual has a known, unresolved history of drug use or alcohol dependency, lacks the ability to comprehend or follow instructions, or would be unlikely or unable to comply with study follow-up requirements.
  • Individual is currently enrolled in another investigational drug or device trial.
  • Individual is currently being treated with any of the following medications:

    • Drugs that cause salt retention (e.g., systemic corticosteroids and fludrocortisone)
    • Acenocoumarol or phenprocoumon that cannot be temporarily stopped for the procedure.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01465724

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UMC Utrecht
Utrecht, Netherlands
Sponsors and Collaborators
UMC Utrecht
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Principal Investigator: Michiel Voskuil, MD, PhD UMC Utrecht
Principal Investigator: Willemien Verloop, MD UMC Utrecht
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Responsible Party: Michiel Voskuil, MD, PhD, Prinicpal investigator, UMC Utrecht Identifier: NCT01465724    
Other Study ID Numbers: 11-265
First Posted: November 6, 2011    Key Record Dates
Last Update Posted: December 30, 2014
Last Verified: December 2014
Keywords provided by Michiel Voskuil, MD, PhD, UMC Utrecht:
Insulin resistance
Insulin sensitivity
blood pressure
Renal denervation
renal sympathetic denervation
renal ablation
Additional relevant MeSH terms:
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Insulin Resistance
Glucose Metabolism Disorders
Metabolic Diseases