title: Endovascular renal denervation: a novel sympatholytic with relevance to chronic kidney disease.
abstract: Endovascular renal denervation (sympathectomy) is a novel procedure developed for the treatment of resistant hypertension. Evidence suggests that it reduces both afferent and efferent sympathetic nerve activity, which may offer clinical benefit over and above any blood pressure-lowering effect. Studies have shown objective improvements in left ventricular mass, ventricular function, central arterial stiffness, central haemodynamics, baroreflex sensitivity and arrhythmia frequency. Benefits have also been seen in insulin resistance, microalbuminuria and glomerular filtration rate. In chronic kidney disease, elevated sympathetic activity has been causally linked to disease progression and cardiovascular sequelae. Effecting a marked reduction in sympathetic hyperactivity may herald a significant step in the management of this and other conditions. In this in-depth review, the pathophysiology and clinical significance of the sympatholytic effects of endovascular renal denervation are discussed.
authors: Department of Medicine , Dunedin School of Medicine , Dunedin , New Zealand.
authors: Neil A
authors: NA
authors: Hoye
authors: Department of Medicine , Dunedin School of Medicine , Dunedin , New Zealand.
authors: James C
authors: JC
authors: Baldi
authors: Department of Medicine , Dunedin School of Medicine , Dunedin , New Zealand.
authors: Tracey L
authors: TL
authors: Putt
authors: Department of Medicine , Dunedin School of Medicine , Dunedin , New Zealand.
authors: John B
authors: JB
authors: Schollum
authors: Department of Medicine , Dunedin School of Medicine , Dunedin , New Zealand.
authors: Gerard T
authors: GT
authors: Wilkins
authors: Department of Medicine , Dunedin School of Medicine , Dunedin , New Zealand.
authors: Robert J
authors: RJ
authors: Walker
keywords: chronic kidney disease; renal denervation; resistant hypertension; sympathetic nervous system