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Renal Denervation: A Review.

Jimena Rey-García1, Raymond R Townsend2

  • 1Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain; Internal Medicine Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|May 22, 2022
PubMed
Summary
This summary is machine-generated.

Renal denervation offers a promising alternative for uncontrolled hypertension, especially when medication adherence is a challenge. This device-based therapy targets renal arteries to lower blood pressure without daily medication or exercise regimens.

Keywords:
Renal denervation (RDN)blood pressurechronic kidney disease (CKD)device interventiondrug-resistant hypertensionhypertensionrenal sympathetic nervesreviewsympathetic nervous system (SNS)

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Area of Science:

  • Nephrology and Cardiovascular Medicine
  • Interventional Cardiology
  • Hypertension Management

Background:

  • Uncontrolled hypertension remains a significant global health concern.
  • Medication nonadherence affects approximately 40% of patients with uncontrolled hypertension.
  • Existing therapies often require daily adherence to medication or physical activity.

Purpose of the Study:

  • To review the mechanisms behind the blood pressure-lowering effects of renal denervation.
  • To summarize the efficacy and safety of renal denervation based on recent controlled trials.
  • To discuss future challenges and advancements in renal denervation therapy.

Main Methods:

  • Review of current knowledge on renal denervation mechanisms.
  • Analysis of efficacy and safety data from controlled trials in hypertensive populations.
  • Exploration of different renal denervation approaches: radiofrequency, ultrasound, and neurolytic agents.

Main Results:

  • Renal denervation is an emerging device-based therapy for hypertension.
  • Multiple approaches to renal denervation are under active investigation.
  • The review synthesizes evidence on the antihypertensive effects, efficacy, and safety of these methods.

Conclusions:

  • Renal denervation presents a potential complementary treatment for resistant hypertension.
  • Optimization of patient selection is crucial for successful renal denervation outcomes.
  • The field of renal denervation is rapidly evolving with promising future developments.