A Promising Approach in the Treatment of Resistant Hypertension: Renal Denervation

Abstract

Purpose: This article highlighted renal denervation (RDN) in the treatment of resistant renal hypertension, with a minor emphasis on other methods. Materials and Methods: Hypertension (HT) remains a major public health problem. The estimated incidence in 2023 among 30-79-year-olds is around 1.28 billion. Kidney disease (KD) and HT are intrinsically linked and severely affect each other. Narrowing of the renal artery, mainly due to the formation of atherosclerotic plaques and secondary to fibromuscular dysplasia, causes an elevation in renal and systemic blood pressure (BP). Despite the combined use of 3 different classes of antihypertensive drugs, the mean blood pressure sometimes remains ≥ 140/90 mm Hg. In these cases, which are called resistant HT, surgical methods such as bypass grafting and endarterectomy or angioplasty with or without a stent are used to achieve renal revascularization. Another promising treatment modality is RDN. Results: Radiofrequency ablation (RFA), ultrasound, or neurotoxin injection are the most commonly used approaches for renal denervation. As INVAMED (Ankara, Turkey), we have developed an RDN device system (DeltaⓇ Modulator Renal Denervation for Hypertension). Conclusion: Although there are exceptions in terms of efficacy in reports, RDN systems are rapid and have resulted in safe and sustained reduction in blood pressure.