Renal Denervation
A Procedure for Hard-to-Control High Blood Pressure
A minimally invasive, FDA-approved catheter procedure that calms overactive nerves along the kidney arteries to help lower blood pressure when lifestyle changes and medications aren't enough.
What is Renal Denervation?
Renal denervation (RDN) is a minimally invasive catheter procedure for people whose high blood pressure remains difficult to control despite healthy lifestyle changes and blood pressure medications. The kidneys and the brain are connected by sympathetic nerves — part of the body's "fight or flight" system — that run along the outside of the kidney arteries. In many people with hard-to-control hypertension, these nerves are overactive and keep blood pressure elevated.
During renal denervation, a thin catheter is guided into the arteries that supply the kidneys, and controlled energy is delivered to calm these overactive nerves. Because the effect works around the clock, it does not depend on remembering to take a pill — but it is designed to work together with your medications and lifestyle, not replace them.
Watch: How the Procedure Works
Important Safety Note
Never stop or change your blood pressure medications — or any medication — without talking to your doctor first, including before or after renal denervation. If you experience symptoms of a medical emergency such as chest pain, severe headache with very high blood pressure, sudden weakness, vision changes, or difficulty breathing, call 911 immediately.
Who is a Candidate for Renal Denervation?
Renal denervation may be an option for you if:
- Your blood pressure remains above goal despite lifestyle changes and multiple blood pressure medications (often called resistant hypertension)
- You have side effects or intolerance that make it hard to take enough medication to control your blood pressure
- You have difficulty taking daily medications consistently and your blood pressure stays uncontrolled as a result
- Secondary causes of high blood pressure (such as untreated sleep apnea or hormonal conditions) have been evaluated
- Imaging shows your kidney artery anatomy is suitable for the procedure
Before considering renal denervation, Dr. Bleszynski confirms that your blood pressure is truly uncontrolled — often with home or 24-hour ambulatory monitoring — and that reversible causes have been addressed. Learn more about hypertension and resistant high blood pressure.
Two FDA-Approved Systems
The FDA has approved two renal denervation systems, both studied in large clinical trials. They reach the kidney arteries the same way — through a small puncture in the groin — but use different types of energy to calm the nerves:
Radiofrequency-Based System
The Medtronic Symplicity Spyral system uses a spiral-shaped catheter that delivers low-level radiofrequency (heat) energy at several points along the kidney arteries and their branches to quiet the overactive nerves.
Ultrasound-Based System
The Recor Paradise system uses a balloon catheter that delivers rings of ultrasound energy through the artery wall to the surrounding nerves, while circulating water in the balloon helps protect the artery lining.
Both approaches have been shown in large clinical trials to lower blood pressure safely. Dr. Bleszynski will discuss which approach best fits your anatomy and situation.
What to Expect: The Renal Denervation Procedure
Preparation
You'll receive sedation to keep you comfortable. The procedure is performed in a catheterization lab, similar to a heart catheterization.
Access
A thin catheter is inserted through a small puncture in the femoral artery in the groin and guided to the arteries supplying the kidneys using X-ray imaging.
Treatment
Controlled energy — radiofrequency or ultrasound, depending on the system — is delivered to calm the overactive nerves along the kidney arteries. The whole procedure typically takes about an hour.
Recovery
The catheter is removed and the puncture site is sealed. Most patients go home the same day or the next morning and return to normal light activities within a few days.
What Benefit Can I Expect?
It's important to have honest expectations about renal denervation:
- •Large clinical trials have shown a modest but durable average reduction in blood pressure, on top of medications.
- •The effect works 24 hours a day, including overnight, and has been durable in studies following patients out to several years.
- •Even modest, sustained blood pressure lowering is linked to lower long-term risk of heart attack, stroke, heart failure, and kidney disease.
- •Individual responses vary — some patients see larger reductions than others, and results cannot be guaranteed.
- •Renal denervation complements — it does not replace — medications and healthy lifestyle habits. Most patients continue their blood pressure medications after the procedure.
Renal Denervation Works Alongside Your Medications
Blood pressure medications and healthy lifestyle habits remain the backbone of treatment — renal denervation adds to them, it doesn't replace them. For a class-by-class guide to common blood pressure medications and their side effects, see our blood pressure medication guide. Never adjust medications on your own — always talk to Dr. Bleszynski first.
Risks of Renal Denervation
Renal denervation has a strong safety record in clinical trials, but like any procedure it carries some risk:
- •Access-site issues — bruising, soreness, or bleeding where the catheter enters the artery in the groin; these are the most common and usually resolve on their own
- •Rare injury to the kidney artery — such as narrowing or damage to the vessel wall, which is uncommon in clinical studies
- •Temporary discomfort — some patients notice back or flank discomfort during or shortly after the procedure
Dr. Bleszynski will review your individual risks and answer all of your questions before any decision is made.
Frequently Asked Questions About Renal Denervation
What is renal denervation and how does it work?
Renal denervation (RDN) is a minimally invasive catheter procedure that calms overactive nerves running along the arteries to the kidneys. These sympathetic nerves help regulate blood pressure, and in many people with hard-to-control hypertension they are overactive. By delivering gentle energy to quiet these nerves, RDN helps lower blood pressure around the clock.
Who is a candidate for renal denervation?
Renal denervation is generally considered for adults whose blood pressure remains above goal despite lifestyle changes and blood pressure medications, or who cannot tolerate enough medication to reach their goal. A full evaluation — including confirming true resistant hypertension and checking the kidney artery anatomy — determines whether the procedure is right for you.
Does renal denervation mean I can stop my blood pressure medications?
No. Renal denervation is designed to work alongside your medications and lifestyle changes, not replace them. Some patients may eventually be able to simplify their regimen, but any medication change should only ever be made by your doctor. Never stop or change a medication on your own.
How much does renal denervation lower blood pressure?
In large clinical trials, renal denervation produced a modest but durable average reduction in blood pressure, on top of medications, with the effect maintained in studies following patients out to several years. Individual results vary — some patients respond more than others — which is why careful patient selection and follow-up matter.
Is renal denervation safe?
Renal denervation has a strong safety record in clinical trials. The most common issues are bruising or soreness at the access site in the groin. Serious complications, such as injury to the kidney artery, are rare. Dr. Bleszynski will review your individual risks during your consultation.
How long is the procedure and the recovery?
The procedure typically takes about an hour. It is performed through a small puncture in the femoral artery in the groin, and most patients go home the same day or the next morning. Most people return to normal light activities within a few days.
Quick Facts
- Procedure Time
- About 1 hour
- Access
- Femoral artery (groin)
- Hospital Stay
- Same or next day
- Return to Activities
- Few days
- Implant Left Behind
- None
FDA Approved
Two systems, since 2023
Both the radiofrequency-based and ultrasound-based renal denervation systems are FDA approved and supported by large clinical trials.
Medication Reminder
Never stop or change your blood pressure medications without talking to your doctor — before or after renal denervation. For emergencies, call 911.
Blood Pressure Still Too High?
If your blood pressure remains uncontrolled despite medications and lifestyle changes, find out whether renal denervation could help.
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