Renal denervation: Current implications and future perspectives

Jianzhong Xu, Dagmara Hering, Yusuke Sata, Antony Walton, Henry Krum, Murray D. Esler, Markus P. Schlaich

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

SNS (sympathetic nervous system) activation is a common feature of arterial hypertension and hasbeen demonstrated to contribute to the development and progression of the hypertensive state. Persuasive evidence suggests a strong association between SNS overactivity and variety of disease states, including chronic renal failure, insulin resistance, congestive heart failure, sleep apnoea, ventricular arrhythmias and others. Although sympatholytic agents are available to target SNS overactivity pharmacologically, they are not widely used in clinical practice, leaving the SNS unopposed in many patients. The recent introduction of catheter-based renal denervation as an alternative approach to targetthe SNS therapeutically has been demonstrated to result in a clinically relevant blood pressure reduction in patients with resistant hypertension, presumably through its effects on both efferent and afferent renal nerve traffic. Available data on this interventional procedure demonstrate a favourable vascular and renal safety profile. Preliminary data obtained primarily from small and mostly uncontrolled studies in related disease states often characterized by overactivity of the SNS are promising, but require confirmation in appropriately designed clinical trials. In the present paper, we briefly review the physiology of the renal nerves and their role in hypertension and other relevant disease states, summarize the data currently available from clinical studies pertaining to the safety and efficacy of renal denervation in resistant hypertension, discuss potential future implications and the available data supporting such a role for renal denervation, and describe some of the newer devices currently under investigation to achieve improved blood pressure control via renal denervation.

Original languageEnglish
Pages (from-to)41-53
Number of pages13
JournalClinical Science
Volume126
Issue number1
DOIs
Publication statusPublished - 2014
Externally publishedYes

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Denervation
Sympathetic Nervous System
Kidney
Hypertension
Sympatholytics
Blood Pressure
Safety
Sleep Apnea Syndromes
Chronic Kidney Failure
Blood Vessels
Insulin Resistance
Cardiac Arrhythmias
Catheters
Heart Failure
Clinical Trials
Equipment and Supplies

Cite this

Xu, J., Hering, D., Sata, Y., Walton, A., Krum, H., Esler, M. D., & Schlaich, M. P. (2014). Renal denervation: Current implications and future perspectives. Clinical Science, 126(1), 41-53. https://doi.org/10.1042/CS20120581
Xu, Jianzhong ; Hering, Dagmara ; Sata, Yusuke ; Walton, Antony ; Krum, Henry ; Esler, Murray D. ; Schlaich, Markus P. / Renal denervation : Current implications and future perspectives. In: Clinical Science. 2014 ; Vol. 126, No. 1. pp. 41-53.
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Xu, J, Hering, D, Sata, Y, Walton, A, Krum, H, Esler, MD & Schlaich, MP 2014, 'Renal denervation: Current implications and future perspectives' Clinical Science, vol. 126, no. 1, pp. 41-53. https://doi.org/10.1042/CS20120581

Renal denervation : Current implications and future perspectives. / Xu, Jianzhong; Hering, Dagmara; Sata, Yusuke; Walton, Antony; Krum, Henry; Esler, Murray D.; Schlaich, Markus P.

In: Clinical Science, Vol. 126, No. 1, 2014, p. 41-53.

Research output: Contribution to journalArticle

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T2 - Current implications and future perspectives

AU - Xu, Jianzhong

AU - Hering, Dagmara

AU - Sata, Yusuke

AU - Walton, Antony

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AU - Esler, Murray D.

AU - Schlaich, Markus P.

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Xu J, Hering D, Sata Y, Walton A, Krum H, Esler MD et al. Renal denervation: Current implications and future perspectives. Clinical Science. 2014;126(1):41-53. https://doi.org/10.1042/CS20120581