Cor Vasa 2011, 53(10):517-521 | DOI: 10.33678/cor.2011.130

Renal denervation: the hope for patients with refractory hypertension?

Petr Widimský1,*, Pavel Osmančík1, Jiří Widimský jr.2
1 Kardiocentrum, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha
2 III. interní klinika, 1. lékařská fakulta Univerzity Karlovy a Všeobecné fakultní nemocnice, Praha, Česká republika

Refractory hypertension carries high risk of complications. Renal denervation (RDN) is a new invasive method of catheter-based radiofrequency ablation of the sympathetic nerves located around renal arteries. The initial clinical experience showed promising and long (2 years) lasting decreases in blood pressure. RDN has provided interesting results also in patients with hypertension plus heart failure and among diabetics with hypertension. This article reviews the published data and provides insight into the methodology of RDN.

Keywords: Renal denervation; Refractory hypertension; Radiofrequency ablation; Sympathetic nerve block; Invasive cardiology

Published: October 1, 2011  Show citation

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Widimský P, Osmančík P, Widimský J. Renal denervation: the hope for patients with refractory hypertension? Cor Vasa. 2011;53(10):517-521. doi: 10.33678/cor.2011.130.
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References

  1. Smithwick RH, Thompson JE. Splanchnicectomy for essential hypertension; results in 1,266 cases. J Am Med Assoc 1953;152:1501-1504. Go to original source... Go to PubMed...
  2. Krum H, Schlaich M, Whitbourn R, et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet 2009;373:1275-1281. Go to original source... Go to PubMed...
  3. Symplicity HTN-1 Investigators. Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months. Hypertension 2011;57:911-917. Go to PubMed...
  4. Esler MD, Krum H, Sobotka PA, et al. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet 2010;376:1903-1909. Go to original source... Go to PubMed...
  5. Sobotka PA, Mahfoud F, Schlaich MP, et al. Sympatho-renal axis in chronic disease. Clin Res Cardiol 2011; epub ahead of print. Go to original source... Go to PubMed...
  6. DiBona GF, Kopp UC. Neural control of renal function. Physiol Rev 1997;77:75-197. Go to original source... Go to PubMed...
  7. Hausberg M, Kosch M, Harmelink P, et al. Sympathetic nerve activity in end-stage renal disease. Circulation 2002;106:1974-1979. Go to original source... Go to PubMed...
  8. Schlaich MP, Sobotka PA, Krum H, et al. Renal sympathetic-nerve ablation for uncontrolled hypertension. N Engl J Med 2009;361:932-934. Go to original source... Go to PubMed...
  9. Esler M, Schlaich M, Sobotka PA. Catheter-based renal denervation reduces total body and renal noradrenaline spillover and blood pressure in resistant hypertension. J Hypertens 2009;27(Suppl 4):S167.
  10. Kaye DM, Esler M, Kingwell B, et al. Functional and neurochemical evidence for partial cardiac sympathetic reinnervation after cardiac transplantation in humans. Circulation 1993;88:1110-1118. Go to original source... Go to PubMed...
  11. Hansen JM, Abildgaard U, Fogh-Andersen N, et al. The transplanted human kidney does not achieve functional reinnervation. Clin Sci (Lond) 1994;87:13-20. Go to original source... Go to PubMed...
  12. Hoobler SW, Manning JT, Paine WG, et al. The effects of splanchnicectomy on the blood pressure in hypertension; a controlled study. Circulation 1951;4:173-83. Go to original source... Go to PubMed...
  13. Mahfoud F, Schlaich M, Kindermann I, et al. Effect of renal sympathetic denervation on glucose metabolism in patients with resistant hypertension: a pilot study. Circulation 2011;123:1940-1946. Go to original source... Go to PubMed...
  14. Witkowski A, Prejbisz A, Florczak E, et al. Effects of Renal Sympathetic Denervation on Blood Pressure, Sleep Apnea Course, and Glycemic Control in Patients With Resistant Hypertension and Sleep Apnea. Hypertension 2011;58:559-565. Go to original source... Go to PubMed...
  15. Grassi G, Dell'Oro R, Quarti-Trevano F, et al. Neuroadrenergic and reflex abnormalities in patients with metabolic syndrome. Diabetologia 2005;48: 1359-1365. Go to original source... Go to PubMed...
  16. Widimský J jr, Cífková R, Špinar J, et al. Doporučení diagnostických a léčebných postupů u arteriální hypertenze - verze 2007. Cor Vasa 2008;50: K5-K22.
  17. Francis GS, Cohn JN, Johnson G, et al. Plasma norepinephrine, plasma renin activity, and congestive heart failure. Relations to survival and the effects of therapy in V-HeFT II. The V-HeFT VA Cooperative Studies Group. Circulation 1993;87:VI40-48.
  18. Hasking GJ, Esler MD, Jennings GL, et al. Norepinephrine spillover to plasma in patients with congestive heart failure: evidence of increased overall and cardiorenal sympathetic nervous activity. Circulation 1986;73:615-621. Go to original source... Go to PubMed...
  19. Kaplan NM. The deadly quartet. Upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch Intern Med 1989;149:1514-1520. Go to original source... Go to PubMed...
  20. Flaa A, Aksnes TA, Kjeldsen SE, et al. Increased sympathetic reactivity may predict insulin resistance: an 18-year follow-up study. Metabolism 2008;57: 1422-1427. Go to original source... Go to PubMed...




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