Renal denervation: recent developments in clinical and preclinical research.

IF 2.2 3区医学 Q3 PERIPHERAL VASCULAR DISEASE

Current Opinion in Nephrology and Hypertension Pub Date : 2023-09-01 DOI:10.1097/MNH.0000000000000908

Paul Drawz, Daniel Baumann, Alex Dayton

{"title":"Renal denervation: recent developments in clinical and preclinical research.","authors":"Paul Drawz, Daniel Baumann, Alex Dayton","doi":"10.1097/MNH.0000000000000908","DOIUrl":null,"url":null,"abstract":"Purpose of review: Renal denervation represents a new dimension to hypertension treatment, with multiple device manufacturers seeking premarket FDA approval currently. Interest in the efficacy and safety of the treatment has spurred compelling mechanistic studies into the function of renal nerves and downstream impacts of denervation.Recent findings: A trial of the ultrasound Paradise Catheter system (RADIANCE II) found a 6.3 mmHg reduction in SBP relative to sham controls. A trial of the Symplicity Spyral system (SPYRAL HTN-ON MED) found an insignificant reduction in SBP relative to sham controls. Individuals were taking antihypertensive medications during the study, and investigators note the sham group experienced a larger medication burden than the denervated group. Recent preclinical studies have evaluated potential risks of renal denervation, how sympathetic activity broadly is affected, as well as identifying possible biomarkers to identify individuals where denervation would be more successful.Summary: Studies of renal denervation continue to find a robust antihypertensive effect, especially in studies wherein medications are withdrawn. Further investigation into mechanisms and indicators for usage of the technique will be important in identifying the patient population most likely to benefit from usage of renal denervation.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Nephrology and Hypertension","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MNH.0000000000000908","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose of review: Renal denervation represents a new dimension to hypertension treatment, with multiple device manufacturers seeking premarket FDA approval currently. Interest in the efficacy and safety of the treatment has spurred compelling mechanistic studies into the function of renal nerves and downstream impacts of denervation.

Recent findings: A trial of the ultrasound Paradise Catheter system (RADIANCE II) found a 6.3 mmHg reduction in SBP relative to sham controls. A trial of the Symplicity Spyral system (SPYRAL HTN-ON MED) found an insignificant reduction in SBP relative to sham controls. Individuals were taking antihypertensive medications during the study, and investigators note the sham group experienced a larger medication burden than the denervated group. Recent preclinical studies have evaluated potential risks of renal denervation, how sympathetic activity broadly is affected, as well as identifying possible biomarkers to identify individuals where denervation would be more successful.

Summary: Studies of renal denervation continue to find a robust antihypertensive effect, especially in studies wherein medications are withdrawn. Further investigation into mechanisms and indicators for usage of the technique will be important in identifying the patient population most likely to benefit from usage of renal denervation.

查看原文本刊更多论文

肾去神经支配:临床和临床前研究的最新进展。

审查目的:肾去神经治疗代表了高血压治疗的一个新维度，目前有多家器械制造商正在寻求FDA的上市前批准。对治疗的有效性和安全性的兴趣刺激了对肾神经功能和去神经支配下游影响的机制研究。最近的发现:一项超声天堂导管系统(RADIANCE II)的试验发现，与假对照组相比，收缩压降低了6.3 mmHg。一项关于simplicity Spyral系统(Spyral HTN-ON MED)的试验发现，与假对照相比，收缩压的降低并不显著。个体在研究期间服用抗高血压药物，研究者注意到假手术组比去神经组承受更大的药物负担。最近的临床前研究评估了肾去神经支配的潜在风险，交感神经活动是如何受到广泛影响的，以及确定可能的生物标志物，以确定去神经支配更成功的个体。总结:肾去神经支配的研究继续发现强大的降压作用，特别是在停药的研究中。进一步研究该技术的使用机制和指标对于确定最有可能从肾去神经治疗中获益的患者群体将是重要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Current Opinion in Nephrology and Hypertension 医学-泌尿学与肾脏学

CiteScore

5.70

自引率

6.20%

发文量

132

审稿时长

6-12 weeks

期刊介绍： A reader-friendly resource, Current Opinion in Nephrology and Hypertension provides an up-to-date account of the most important advances in the field of nephrology and hypertension. Each issue contains either two or three sections delivering a diverse and comprehensive coverage of all the key issues, including pathophysiology of hypertension, circulation and hemodynamics, and clinical nephrology. Current Opinion in Nephrology and Hypertension is an indispensable journal for the busy clinician, researcher or student.