Renal denervation: intractable hypertension and beyond.
BACKGROUND
Hypertension continues to be a major burden of public health concern despite the recent advances and proven benefit of pharmacological therapy. A certain subset of patients has hypertension resistant to maximal medical therapy and appropriate lifestyle measures. A novel catheter-based technique for renal denervation (RDN) as a new therapeutic avenue has great promise for the treatment of refractory hypertension.


CONCLUSIONS
This review included the physiology of the renal sympathetic nervous system and the renal nerve anatomy. Furthermore, the RDN procedure, technology systems, and RDN clinical trials as well as findings besides antihypertensive effects were discussed. Findings on safety and efficacy seem to suggest that renal sympathetic denervation could be of therapeutic benefit in refractory hypertensive patients. Despite the fast pace of development in RDN therapies, only initial and very limited clinical data are available. Large gaps in knowledge concerning the long-term effects and consequences of RDN still exist, and solid, randomized data are warranted.
Department of Nephrology, San Bortolo Hospital, Italy ; International Renal Research Institute Vicenza (IRRIV), Italy ; Cardio-Metabolic Center, BNH Hospital, Bangkok, Thailand.
Wassawon
W
Ariyanon
Department of Nephrology, San Bortolo Hospital, Italy ; International Renal Research Institute Vicenza (IRRIV), Italy ; Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Huijuan
H
Mao
Department of Nephrology, San Bortolo Hospital, Italy ; International Renal Research Institute Vicenza (IRRIV), Italy.
Zelal
Z
Adýbelli
Department of Cardiology, City Hospital, Milan, Italy.
Silvia
S
Romano
Department of Nephrology, San Bortolo Hospital, Italy ; International Renal Research Institute Vicenza (IRRIV), Italy.
Mariapia
M
Rodighiero
Department of Cardiology, City Hospital, Milan, Italy.
Bernhard
B
Reimers
Department of Cardiology, San Bortolo Hospital, Vicenza, Italy.
Luigi
L
La Vecchia
Department of Nephrology, San Bortolo Hospital, Italy ; International Renal Research Institute Vicenza (IRRIV), Italy.
Claudio
C
Ronco
Hypertension; Renal denervation; Renal sympathetic nervous system