» Articles » PMID: 24244757

Novel Approaches for the Treatment of the Patient with Resistant Hypertension: Renal Nerve Ablation

Overview
Publisher Springer
Date 2013 Nov 19
PMID 24244757
Citations 4
Authors
Affiliations
Soon will be listed here.
Abstract

Sympathetic innervation of the kidneys plays a major role in the pathogenesis of hypertension through modulation of renin secretion, glomerular filtration rate and renal absorption of sodium. Targeted interventions for renal nerve ablation are being developed for treatment of drug resistant hypertension in the USA and rest of the world. Early studies with the use of radiofrequency based renal denervation systems have shown encouraging results with significant reduction of blood pressure in patients inadequately controlled despite nearly maximal drug therapy regimens. Thus far, the renal denervation procedure has been associated with minimal side effects. Long term efficacy and safety beyond 3 years needs to be determined for renal nerve ablation. This review focuses on the physiology of the renal sympathetic system, the rationale for renal nerve ablation and current evidence in support of the available therapeutic renal denervation systems.

Citing Articles

Efficacy and safety of 3D reconstruction and basket multi-electrode renal denervation (RDN) for refractory hypertensive patients with chronic kidney disease.

Cai H, Fang Z, Wu X, Zhou W, Lin J, Peng F J Clin Hypertens (Greenwich). 2024; 26(4):338-348.

PMID: 38430475 PMC: 11007785. DOI: 10.1111/jch.14781.


Epididymal Fat-Derived Sympathoexcitatory Signals Exacerbate Neurogenic Hypertension in Obese Male Mice Exposed to Early Life Stress.

Dalmasso C, Leachman J, Ghuneim S, Ahmed N, Schneider E, Thibault O Hypertension. 2021; 78(5):1434-1449.

PMID: 34601958 PMC: 8516729. DOI: 10.1161/HYPERTENSIONAHA.121.17298.


Clinical Characteristics of Resistant vs. Refractory Hypertension in a Population of Hypertensive Afrodescendants.

Macedo C, Junior R, Macedo I Arq Bras Cardiol. 2020; 115(1):31-39.

PMID: 32236323 PMC: 8384326. DOI: 10.36660/abc.20190218.


Raising the Bar in Renal Sympathetic Denervation Research and Reporting.

Lee J, Rick Turner J J Clin Hypertens (Greenwich). 2015; 18(2):89-94.

PMID: 26370742 PMC: 8031579. DOI: 10.1111/jch.12666.

References
1.
Hering D, Mahfoud F, Walton A, Krum H, Lambert G, Lambert E . Renal denervation in moderate to severe CKD. J Am Soc Nephrol. 2012; 23(7):1250-7. PMC: 3380649. DOI: 10.1681/ASN.2011111062. View

2.
Esler M, Jennings G, Korner P, Willett I, Dudley F, Hasking G . Assessment of human sympathetic nervous system activity from measurements of norepinephrine turnover. Hypertension. 1988; 11(1):3-20. DOI: 10.1161/01.hyp.11.1.3. View

3.
Witkowski A, Prejbisz A, Florczak E, KADziela J, Sliwinski P, Bielen P . Effects of renal sympathetic denervation on blood pressure, sleep apnea course, and glycemic control in patients with resistant hypertension and sleep apnea. Hypertension. 2011; 58(4):559-65. DOI: 10.1161/HYPERTENSIONAHA.111.173799. View

4.
Mahfoud F, Luscher T, Andersson B, Baumgartner I, Cifkova R, DiMario C . Expert consensus document from the European Society of Cardiology on catheter-based renal denervation. Eur Heart J. 2013; 34(28):2149-57. DOI: 10.1093/eurheartj/eht154. View

5.
Evelyn K, Alexander F, Cooper S . Effect of sympathectomy on blood pressure in hypertension; a review of 13 years' experience of the Massachusetts General Hospital. J Am Med Assoc. 1949; 140(7):592-602. DOI: 10.1001/jama.1949.02900420012004. View