Renal Denervation: A Practical Guide for Health Professionals Managing Hypertension

Author:

Schmieder Roland1ORCID,Burnier Michel2ORCID,East Cara3ORCID,Tsioufis Konstantinos4ORCID,Delaney Sean5ORCID

Affiliation:

1. University Hospital Erlangen, Department of Nephrology and Hypertension, Erlangen, Germany

2. University Hospital, Lausanne, Switzerland

3. Cardiology, Baylor Heart & Vascular Hospital, Dallas, TX, US

4. National and Kapodistrian University of Athens, 1st Cardiology Clinic, Hippocratio Hospital, Athens, Greece

5. Radcliffe Medical Education, Bourne End, UK

Abstract

Growing evidence demonstrates the suitability of renal denervation in a broad population of patients; however, questions remain over its suitability and practical implementation. Given the rapidity of emerging data, this has been a challenging field for potential adopters to navigate. The purpose of this article is twofold: to provide navigation through emerging clinical data and evolving guidance; and to provide physicians with practical, evidence-based advice for identifying eligible patients and providing appropriate management in the pre- and postintervention settings. Although many of these recommendations are based on existing published guidance documents, we reflect equally on our own experiences of using this technology.

Funder

Medtronic

Publisher

Radcliffe Media Media Ltd

Subject

Cardiology and Cardiovascular Medicine

Reference40 articles.

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2. Bohm M, Kario K, Kandzari DE, et al. Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomised, sham-controlled trial. Lancet 2020;395:1444–51. https://doi.org/10.1016/S0140-6736(20)30554-7; PMID: 32234534.

3. Kandzari DE, Bohm M, Mahfoud F, et al. Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial. Lancet 2018;391:2346–55. https://doi.org/10.1016/S0140-6736(18)30951-6; PMID: 29803589.

4. Mahfoud F, Kandazari DE, Kario K, et al. Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial. Lancet 2022;399:1401–10. https://doi.org/10.1016/S0140-6736(22)00455-X; PMID: 35390320.

5. Azizi M, Sanghvi K, Saxena M, et al. Ultrasound renal denervation for hypertension resistant to a triple medication pill (RADIANCE-HTN Trio): a randomised, multicentre, single-blind, sham-controlled trial. Lancet 2021;397:2476–86. https://doi.org/10.1016/S0140-6736(21)00788-1; PMID: 34010611.

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