Renal Denervation: A Practical Guide for Health Professionals Managing Hypertension

Schmieder, Roland E.; Burnier, Michel; East, Cara; Tsioufis, Costas; Delaney, Sean

doi:10.15420/icr.2022.38

Cited by 5 publications

(2 citation statements)

References 43 publications

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“…Young and elderly patients may be at increased risk of medication nonadherence and, as such, may require closer monitoring. Albeit not without limitations, the use of novel assays like the dried blood spot, which could be performed during an ambulatory visit, liquid chromatography-tandem mass spectrometry, pick-up/refill dates, and urine assays may help assess compliance in these cases [34 ▪ ,35,36]. Adherence to a guideline-directed approach to measuring and diagnosing resistant hypertension is necessary to limit inappropriate interventions.…”

Section: Future Trendsmentioning

confidence: 99%

Controversies related to renal artery denervation and devices

Agwuegbo,

Antia,

Shamaki

et al. 2024

Current Opinion in Cardiology

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Purpose of review This review article discusses the controversies, strengths, and limitations of the current literature on renal artery denervation in the management of resistant hypertension, as well as the future directions of this intervention. Recent findings There have been conflicting data from the different randomized control trials assessing the efficacy of renal artery denervation in the management of resistant hypertension. Summary Renal artery denervation is achieved by ablating the sympathetic nerves surrounding the renal arteries using endovascular ultrasound, radiofrequency, or alcohol. Our review article highlights that renal artery denervation is generally effective in improving blood pressure in patients with resistant hypertension. The Food and Drug Administration (FDA) has recently approved the ReCor Medical Paradise system, and the Symplicity Spyral RDN systems for renal artery denervation.

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Section: Future Trendsmentioning

confidence: 99%

Controversies related to renal artery denervation and devices

Agwuegbo,

Antia,

Shamaki

et al. 2024

Current Opinion in Cardiology

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“…Renal denervation (RDN) is an interventional procedure, which, by ablating the renal sympathetic nerves in close proximity to the renal arteries’ walls, ameliorates the renal sympathetic nervous system (SNS) interactions, that are largely responsible for the renal-induced sympathetic overdrive observed in pathologies including hypertension, heart failure (HF) and metabolic syndrome, and thereby results in reduction of arterial blood pressure (BP) [ 1 – 3 ]. The procedure itself has predominantly emerged as an adjunct to medication intervention for the management of hypertension and specifically resistant hypertension.…”

Section: Introductionmentioning

confidence: 99%

Unravelling the effect of renal denervation on glucose homeostasis: more questions than answers?

Koutra,

Dimitriadis,

Pyrpyris

et al. 2023

Acta Diabetol

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Renal Denervation (RDN) is an interventional, endovascular procedure used for the management of hypertension. The procedure itself aims to ablate the renal sympathetic nerves and to interrupt the renal sympathetic nervous system overactivation, thus decreasing blood pressure (BP) levels and total sympathetic drive in the body. Recent favorable evidence for RDN resulted in the procedure being included in the recent European Guidelines for the management of Hypertension, while RDN is considered the third pillar, along with pharmacotherapy, for managing hypertension. Sympathetic overactivation, however, is associated with numerous other pathologies, including diabetes, metabolic syndrome and glycemic control, which are linked to adverse cardiovascular health and outcomes. Therefore, RDN, via ameliorating sympathetic response, could be also proven beneficial for maintaining an euglycemic status in patients with cardiovascular disease, alongside its BP-lowering effects. Several studies have aimed, over the years, to provide evidence regarding the pathophysiological effects of RDN in glucose homeostasis as well as investigate the potential clinical benefits of the procedure in glucose and insulin homeostasis. The purpose of this review is, thus, to analyze the pathophysiological links between the autonomous nervous system and glycemic control, as well as provide an overview of the available preclinical and clinical data regarding the effect of RDN in glycemic control.

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Exploring Potential Referral Pathways for Renal Artery Denervation and Developing a Centre of Excellence in Ireland

Leahy,

Wagener,

Shahzad

et al. 2024

SN Compr. Clin. Med.

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Arterial hypertension is one of the most significant and prevalent risk factors for cardiovascular disease. Despite widespread awareness of the condition, as well as a multitude of available antihypertensive drug classes, rates of uncontrolled hypertension remain high on a global scale. Frequently, poor compliance with anti-hypertensive medication plays a big role in patients’ inability to attain adequate blood pressure control. In individuals with resistant and/or uncontrolled hypertension, renal denervation is an emerging device-based therapy that has shown to be efficacious and safe in reducing blood pressure in several sham controlled trials. Additionally, it represents a treatment option for patients intolerant to oral pharmacotherapy.University Hospital Galway has been performing renal denervation procedures over the past number of years within multicentre, international sham-controlled trials and registries. Representing a novel and emerging antihypertensive treatment option, sources of referral for renal denervation are diverse and multiple; thus, there is an unmet need for standardised referral structures in Ireland. Herein, we review current and developing referral pathways for renal denervation at our institution, and discuss streamlined patient management and requirements to establish a centre of excellence.

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Renal Denervation: A Practical Guide for Health Professionals Managing Hypertension

Cited by 5 publications

References 43 publications

Controversies related to renal artery denervation and devices

Controversies related to renal artery denervation and devices

Unravelling the effect of renal denervation on glucose homeostasis: more questions than answers?

Exploring Potential Referral Pathways for Renal Artery Denervation and Developing a Centre of Excellence in Ireland

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