Renal Denervation
At my cardiovascular and vascular clinic, I often see patients frustrated by their numbers, despite doing “everything right.” That’s where renal denervation, a cutting-edge minimally invasive procedure to lower blood pressure, comes into the picture.
Key human organs - heart and kidneys - work together in a complex network.
Renal Denervation: A Minimally Invasive Treatment for Resistant Hypertension
When high blood pressure refuses to budge—despite taking multiple medications—you’re not alone. This condition, known as resistant hypertension, affects millions worldwide and puts patients at higher risk for heart attacks, strokes, and kidney failure.
What Is Resistant Hypertension?
Resistant hypertension is defined as blood pressure that remains elevated despite using three or more antihypertensive medications, including a diuretic, at optimal doses. This type of high blood pressure can be due to several factors—including lifestyle, genetics, or an overactive sympathetic nervous system.
What Is Renal Denervation?
Renal denervation is a catheter-based procedure designed to reduce overactivity in the renal sympathetic nerves—nerves that wrap around the arteries supplying the kidneys. These nerves play a key role in regulating blood pressure, and when they become overactive, they can drive blood pressure dangerously high.
During the procedure:
- A thin catheter is inserted through the femoral artery in the groin.
- It is carefully guided to the renal arteries.
- Radiofrequency or ultrasound energy is delivered to disrupt the surrounding sympathetic nerves.
- The procedure is performed on both kidneys in a single session.
By disrupting nerve signals to the kidneys, the body’s “fight-or-flight” stress response is reduced, allowing for better blood pressure control.
Who Can Benefit from Renal Denervation?
This procedure is most suitable for individuals with:
- Uncontrolled high blood pressure despite lifestyle changes and medications
- Documented resistant hypertension on 3 or more medications
- Elevated sympathetic nerve activity, which may be contributing to their hypertension
A thorough cardiovascular and renal evaluation is essential to determine if you're a good candidate.
Benefits of Renal Denervation
✅ Lowers blood pressure: Studies have shown significant and sustained reductions in blood pressure in eligible patients.
✅ Reduces medication burden: Some patients may be able to lower the dosage of their medications or even discontinue some drugs under close monitoring.
✅ Long-term effects: Early evidence suggests the blood pressure-lowering effects may last several years.
✅ Improves cardiovascular outcomes: Lower blood pressure means a reduced risk of heart attacks, strokes, and kidney disease over time.
Is Renal Denervation Safe?
Yes—renal denervation is generally safe when performed by experienced specialists. As with any procedure, there are some risks, including:
- Pseudoaneurysm or vascular injury
- Mild groin discomfort or bruising
- Rarely, renal artery narrowing or dissection
That’s why careful patient selection and vascular expertise are essential to success.
🧠 Frequently Asked Questions About Renal Denervation
❓ What is renal denervation?
Renal denervation is a minimally invasive procedure that uses radiofrequency or ultrasound energy to disrupt overactive nerves in the renal arteries, which supply the kidneys. These nerves contribute to high blood pressure. The procedure is used to treat resistant hypertension when medications alone are not enough.
❓ Who is a candidate for renal denervation?
Renal denervation is typically recommended for patients with resistant hypertension—defined as high blood pressure that persists despite using at least three antihypertensive medications, including a diuretic. A thorough cardiovascular evaluation is needed to confirm suitability.
❓ How does renal denervation lower blood pressure?
The procedure targets the sympathetic nerves around the renal arteries. These nerves can be overactive in people with high blood pressure. By disrupting these nerves, renal denervation helps reduce nerve signals that raise blood pressure, leading to better blood pressure control.
❓ Is renal denervation safe?
Yes, renal denervation is considered safe when performed by experienced specialists. Most patients recover quickly with minimal discomfort. Rare risks include vascular complications like pseudoaneurysm, artery narrowing, or bleeding at the catheter site.
❓ How effective is renal denervation?
Clinical trials have shown that renal denervation can result in significant and sustained reductions in blood pressure, especially in patients with confirmed resistant hypertension. Some patients may also reduce their medication load over time.
❓ How long does the renal denervation procedure take?
The procedure typically takes about 45 to 60 minutes and is done in a catheterization lab under local anesthesia and sedation. Most patients go home the same day or after overnight observation.
❓ Will I still need blood pressure medication after renal denervation?
Possibly. Renal denervation may help reduce the number or dosage of medications, but many patients still need some medication. The goal is better blood pressure control with fewer side effects and improved long-term outcomes.
❓ What is recovery like after renal denervation?
Most patients resume light activity within 24–48 hours. You may have some mild soreness at the groin access site. Follow-up visits and blood pressure monitoring are important to assess the effectiveness of the procedure.
Take Control of Your Blood Pressure
If you’ve been told your blood pressure is hard to control—or if you’re tired of taking multiple pills every day—renal denervation may offer a new path forward.