title: [Expert consensus statement on interventional renal sympathetic denervation for hypertension treatment].
abstract: This commentary summarizes the expert consensus and recommendations of the working group 'Herz und Niere' of the German Society of Cardiology (DGK), the German Society of Nephrology (DGfN) and the German Hypertension League (DHL) on renal denervation for antihypertensive treatment. Renal denervation is a new, interventional approach to selectively denervate renal afferent and efferent sympathetic fibers. Renal denervation has been demonstrated to reduce office systolic and diastolic blood pressure in patients with resistant hypertension, defined as systolic office blood pressure ≥ 160 mm Hg and ≥ 150 mm Hg in patients with diabetes type 2, which should currently be used as blood pressure thresholds for undergoing the procedure. Exclusion of secondary hypertension causes and optimized antihypertensive drug treatment is mandatory in every patient with resistant hypertension. In order to exclude pseudoresistance, 24-hour blood pressure measurements should be performed. Preserved renal function was an inclusion criterion in the Symplicity studies, therefore, renal denervation should be only considered in patients with a glomerular filtration rate > 45 ml/min. Adequate centre qualification in both, treatment of hypertension and interventional expertise are essential to ensure correct patient selection and procedural safety. Long-term follow-up after renal denervation and participation in the German Renal Denervation (GREAT) Registry are recommended to assess safety and efficacy after renal denervation over time.
authors: Klinik für Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar. felix.mahfoud@uniklinikum-saarland.de
authors: F
authors: F
authors: Mahfoud
authors: O
authors: O
authors: Vonend
authors: H
authors: H
authors: Bruck
authors: W
authors: W
authors: Clasen
authors: S
authors: S
authors: Eckert
authors: B
authors: B
authors: Frye
authors: H
authors: H
authors: Haller
authors: M
authors: M
authors: Hausberg
authors: U C
authors: UC
authors: Hoppe
authors: J
authors: J
authors: Hoyer
authors: K
authors: K
authors: Hahn
authors: T
authors: T
authors: Keller
authors: B K
authors: BK
authors: Krämer
authors: R
authors: R
authors: Kreutz
authors: S A
authors: SA
authors: Potthoff
authors: H
authors: H
authors: Reinecke
authors: R
authors: R
authors: Schmieder
authors: V
authors: V
authors: Schwenger
authors: U
authors: U
authors: Kintscher
authors: M
authors: M
authors: Böhm
authors: L C
authors: LC
authors: Rump
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D017115:Catheter Ablation; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012042:Registries; D012077:Renal Artery / Q000294:innervation*; D013562:Sympathectomy / Q000379:methods*; D055815:Young Adult
chemical_list: D001786:Blood Glucose