Renal denervation benefits in chronic kidney disease: An updated review

Abstract

Hypertension (HTN) may not be properly controlled despite the ideal blood pressure (BP)-lowering drugs and good patient compliance. These scenarios emphasize the need for innovative approaches to treat HTN cases that are difficult to manage pharmaceutically. Numerous recent studies have documented the effectiveness of renal denervation (RDN) therapy in reducing sympathetic nerve system (SNS) overactivity. Although this therapy is invasive and expensive, its appropriate use in specific cases is still being refined. SNS overactivity is documented in HTN, chronic kidney disease (CKD), and end-stage renal disease patients. Over the past decade, RDN therapy has been used in different countries to treat HTN, with a positive response in most cases. However, some hospitals have no resources or interventionists to perform these procedures. Nonetheless, there is an increased number of physicians expressing interest in using RDN in sustained HTN therapy and prevention of CKD progression. There are no consensus guidelines worldwide; however, some societies have developed guidelines for using RDN based on updated information covering the BP-lowering mechanism, efficacy, patient selection, post- and preprocedural assessment, and procedural safety. In this review, we aimed to evaluate the effectiveness of the RDN procedure for treating HTN and prevention of CKD development and progression.