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Renal Denervation in Human Hypertension: Mechanisms, Current Findings, and Future Prospects

  • SECONDARY HYPERTENSION: ADRENAL AND NERVOUS SYSTEM MECHANISMS (S OPARIL AND KH BERECEK, SECTION EDITORS)
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Abstract

Denervating the human kidney to improve blood pressure control is an old therapeutic concept first applied on a larger scale by surgeons in the 1920s. With the advent of modern pharmacology and the development of powerful drugs to lower blood pressure, approaches to directly target the sympathetic nerves were more or less abandoned. Over the past 2–3 years, however, we have witnessed enormous renewed interest in novel and minimally invasive device-based approaches to specifically target the renal nerves. The enthusiasm is fueled by promising results from proof-of-concept studies and clinical trials demonstrating convincing blood pressure–lowering effects in the majority of treated patients, and perhaps even more so by observations indicating potential additional benefits relating to common comorbidities of hypertension, such as impaired glucose metabolism, renal impairment, left ventricular hypertrophy, and others. Herein we review the current findings and assess whether these high hopes are justified.

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Disclosure

Parts of this work were funded by grants from the National Health and Research Council of Australia (NHMRC) and the Victorian Government’s Operational Infrastructure Support Program.

Dr. Schlaich has served on a board for, served as a consultant for, served on the speaker’s bureau for, received grant support from, and received travel support from Ardian/Medtronic.

Dr. Schlaich and Dr. Esler are supported by career fellowships from the NHMRC.

Dr. Hering is currently supported by Research Fellowship from the Foundation for Polish Science KOLUMB/2010-1.

Dr. Schlaich, Dr. Krum, and Dr. Esler are investigators in ClinicalTrials.gov: NCT00483808 and ClinicalTrials.gov: NCT 00551304, sponsored by Ardian/Medtronic.

Dr. Sobotka is an employee of Ardian/Medtronic.

Dr. Krum has served on the speaker’s bureau for Ardian/Medtronic.

Dr. Esler has had travel expenses/accommodations covered/reimbursed by, has served as a consultant for, has received grant support from, and has served on the speakers’ bureau/developed educational presentations for Ardian/Medtronic.

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Authors and Affiliations

  1. Neurovascular Hypertension and Kidney Disease Laboratory, Baker IDI Heart and Diabetes Institute, P.O. Box 6492, St. Kilda Road Central, Melbourne, Victoria, 8008, Australia

    Markus P. Schlaich, Dagmara Hering & Murray D. Esler

  2. Department of Cardiology, Hennepin County Medical Center, Minneapolis, Minnesota, USA

    Paul A. Sobotka

  3. Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University/Alfred Hospital, Melbourne, Victoria, 3004, Australia

    Henry Krum

Authors
  1. Markus P. Schlaich
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  2. Dagmara Hering
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  3. Paul A. Sobotka
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  4. Henry Krum
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  5. Murray D. Esler
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Correspondence to Markus P. Schlaich.

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Schlaich, M.P., Hering, D., Sobotka, P.A. et al. Renal Denervation in Human Hypertension: Mechanisms, Current Findings, and Future Prospects. Curr Hypertens Rep 14, 247–253 (2012). https://doi.org/10.1007/s11906-012-0264-9

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