Wassawon Ariyanon1, Huijuan Mao2, Zelal Adýbelli3, Silvia Romano4, Mariapia Rodighiero3, Bernhard Reimers4, Luigi La Vecchia5, Claudio Ronco3. 1. Department of Nephrology, San Bortolo Hospital, Italy ; International Renal Research Institute Vicenza (IRRIV), Italy ; Cardio-Metabolic Center, BNH Hospital, Bangkok, Thailand. 2. 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. 3. Department of Nephrology, San Bortolo Hospital, Italy ; International Renal Research Institute Vicenza (IRRIV), Italy. 4. Department of Cardiology, City Hospital, Milan, Italy. 5. Department of Cardiology, San Bortolo Hospital, Vicenza, Italy.
Abstract
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. SUMMARY: 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.
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. SUMMARY: 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 hypertensivepatients. 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.
Entities:
Keywords:
Hypertension; Renal denervation; Renal sympathetic nervous system
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