Renal Denervation
Treatment for Resistant Hypertension
A minimally invasive procedure offering new hope for patients whose high blood pressure remains uncontrolled despite multiple medications.
What is Renal Denervation?
Renal denervation (RDN) is a catheter-based procedure that targets the nerves surrounding the arteries that supply your kidneys. These renal nerves are part of the sympathetic nervous system and play an important role in regulating blood pressure.
In patients with resistant hypertension, the sympathetic nervous system is often overactive, contributing to elevated blood pressure. By using radiofrequency or ultrasound energy to reduce the activity of these nerves, renal denervation can help lower blood pressure when medications alone aren't enough.
Understanding Resistant Hypertension
Resistant hypertension is defined as blood pressure that remains above goal levels despite treatment with three or more antihypertensive medications (including a diuretic) at optimal doses.
Why It Matters
- •Affects 10-15% of patients with hypertension
- •Significantly increases risk of heart attack and stroke
- •Can lead to heart failure and kidney disease
- •Often frustrating when medications don't work
Common Contributing Factors
- •Overactive sympathetic nervous system
- •Excess sodium retention
- •Sleep apnea
- •Obesity and metabolic factors
Who May Benefit from Renal Denervation?
Renal denervation may be appropriate for patients who:
- Have resistant hypertension (uncontrolled blood pressure despite 3+ medications)
- Are taking their blood pressure medications as prescribed
- Have been evaluated and other treatable causes of hypertension have been ruled out
- Have suitable kidney artery anatomy for the procedure
- Are motivated to achieve better blood pressure control
- Understand that medications will likely still be needed after the procedure
The Renal Denervation Procedure
Preparation
You'll receive conscious sedation to keep you comfortable. The procedure is performed in a catheterization lab.
Access
A small catheter is inserted through an artery in the leg (similar to a heart catheterization) and guided to the kidney arteries using X-ray imaging.
Treatment
The catheter delivers radiofrequency or ultrasound energy to the walls of the renal arteries, reducing the activity of the surrounding nerves. Both kidney arteries are typically treated.
Completion
The catheter is removed and pressure is applied to the leg access site. The entire procedure typically takes about an hour.
What to Expect After Renal Denervation
Recovery
- •Most patients go home same day or next morning
- •Resume normal activities within a few days
- •Continue blood pressure medications initially
Blood Pressure Response
- •Effects develop gradually over weeks to months
- •Blood pressure monitored at regular follow-ups
- •Medication adjustments made based on response
Important: Renal denervation is not a cure for hypertension. It is a tool to help achieve better blood pressure control in combination with lifestyle modifications and medications. Results vary between patients.
Frequently Asked Questions
What is renal denervation?
Renal denervation is a minimally invasive catheter-based procedure that uses radiofrequency energy or ultrasound to reduce the activity of nerves surrounding the kidney arteries. These nerves play a role in regulating blood pressure, and reducing their activity can help lower blood pressure in patients with resistant hypertension.
Who is a candidate for renal denervation?
Renal denervation is designed for patients with resistant hypertension—high blood pressure that remains uncontrolled despite taking three or more blood pressure medications, including a diuretic. Candidates undergo evaluation to ensure they have suitable kidney artery anatomy and no other treatable causes of hypertension.
How much can renal denervation lower blood pressure?
Clinical trials have shown average blood pressure reductions of 5-10 mmHg systolic in the months following the procedure. While this may seem modest, even small reductions in blood pressure significantly decrease the risk of heart attack, stroke, and kidney disease over time.
Is renal denervation safe?
Renal denervation has been extensively studied and has a strong safety profile. The procedure does not affect kidney function. Risks are similar to other catheter-based procedures and include minor bleeding or bruising at the catheter insertion site.
Will I still need blood pressure medications after the procedure?
Most patients continue taking blood pressure medications after renal denervation, though some may be able to reduce the number or dosage of medications over time. The goal is to achieve better blood pressure control, not necessarily to eliminate medications entirely.
Quick Facts
- Procedure Time
- About 1 hour
- Anesthesia
- Conscious sedation
- Hospital Stay
- Same day or overnight
- Return to Activities
- Few days
Blood Pressure Reduction
Clinical trials have demonstrated average systolic blood pressure reductions of 5-10 mmHg, which can significantly reduce cardiovascular risk over time.
Struggling with High Blood Pressure?
If your blood pressure remains high despite multiple medications, renal denervation may help. Schedule a consultation to learn more.
Schedule Consultation(702) 805-5678