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Updated: Feb 11, 2026

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
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Selective vs. Global Renal Denervation: a Case for Less Is More.

Marat Fudim1,2, Asher A Sobotka3, Yue-Hui Yin4

  • 1Duke University Medical Center, Durham, NC, USA.

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|May 3, 2018
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Summary
This summary is machine-generated.

Selective renal denervation (RDN) may offer superior blood pressure control compared to global RDN. Identifying specific nerve fibers through stimulation could improve RDN efficacy and patient outcomes.

Keywords:
Hot spotsHypertensionNerve stimulationRenal denervationRenal nerves

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Area of Science:

  • Nephrology
  • Cardiovascular Physiology
  • Interventional Cardiology

Background:

  • Renal denervation (RDN) aims to reduce sympathetic nervous system activity by ablating renal nerves.
  • Mixed results from recent RDN trials highlight limitations of non-targeted approaches.
  • Understanding renal nerve anatomy and physiology is crucial for optimizing RDN therapy.

Purpose of the Study:

  • To review the fundamentals of renal nerve anatomy and physiology.
  • To explore the concepts of global versus selective RDN.
  • To uncover limitations of non-targeted ablation and the potential benefits of selective RDN.

Main Methods:

  • Review of existing literature on renal nerve anatomy, physiology, and RDN trials.
  • Analysis of heterogeneous responses to global RDN.
  • Exploration of renal nerve stimulation techniques to identify specific fiber populations.

Main Results:

  • Global RDN shows heterogeneous responses, including lack of efficacy or even adverse blood pressure elevations.
  • Renal nerve populations are heterogeneous, with distinct sympatho-stimulatory and sympatho-inhibitory fibers.
  • Renal nerve stimulation can identify "hot spots" of sympathetic activity.

Conclusions:

  • Selective RDN, guided by nerve stimulation, holds promise for improved therapeutic outcomes.
  • Avoiding non-target fibers during RDN may mitigate adverse effects and enhance efficacy.
  • Further research into selective RDN techniques is warranted to optimize blood pressure management.