Renal Denervation

Some people have blood pressure that is very difficult to treat. In these cases, healthy habits and a combination of medications aren’t enough to lower blood pressure to target levels. This is where renal denervation may be an option.

What is Renal Denervation?

It’s a one-time, minimally invasive procedure. It works by disrupting the nerves on the outside of the arteries of the kidneys. These nerves can activate the body’s “fight or flight” response and raise blood pressure.

What to Expect?

To perform the procedure, a doctor will make a small incision in the groin and insert a thin, plastic tube (catheter) that is carefully guided to the blood vessels supplying blood to the kidneys. Heat is applied to disrupt the nerves without damaging the arteries. This is done either with ultrasound or radiofrequency (heat) energy, which is determined by the doctor doing the procedure. 

In general:

• The procedure usually takes 1-2 hours
• Sedation (not general anesthesia) is used to help keep you comfortable
• Unlike some other heart procedures, no stents or implants are used or left behind
• Most people can go home the same day

In studies, renal denervation has been shown to be:

• Safe
• At least as effective in lowering blood pressure as a single blood pressure medicine

But there are some important considerations and things to talk with your care team about to figure out if this treatment is right for you.

1. Other causes of high blood pressure must be ruled out first. You’ll want to be certain that you aren’t taking any medicines that can raise blood pressure.
2. Your kidneys and the arteries supplying blood to them must be healthy. 
3. It may take weeks, even months to see an effect after the procedure.
4. It doesn’t work for everyone. About 1in 4 people won’t see any benefit.
5. Lifestyle changes and medication are still necessary to keep blood pressure where it needs to be.
6. It’s important to be seen by a multidisciplinary care team with expertise in resistant hypertension and performing renal denervation.

Weighing the Benefits and Harms