VascularInterventional
Renal Denervation
A specialized procedure that targets overactive nerves in the kidneys to naturally lower blood pressure in patients with resistant hypertension.
Renal denervation (RDN) is a catheter-based procedure that disrupts sympathetic nerve activity around the renal arteries to lower blood pressure in patients with true resistant hypertension — those who remain hypertensive despite three or more antihypertensive medications.
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Renal denervation safely disrupts the overactive sympathetic nerves surrounding the kidney arteries to lower chronically high blood pressure.
Turning Down the Nerve Signals That Drive Blood Pressure
The kidneys are wired into the body's sympathetic nervous system — the same “fight or flight” network that raises the pulse. In some people with stubborn high blood pressure these nerves, running in the wall of the renal arteries, are overactive, constantly pushing the pressure up and telling the body to hold on to salt and fluid.
Renal denervation quietens them. A catheter passed into each renal artery delivers short bursts of radiofrequency or ultrasound energy to the artery wall, interrupting the nerve traffic. It is not a cure for hypertension and it does not replace tablets, but it shifts the whole 24-hour pressure profile down by a useful amount.
Renal denervation quietens them. A catheter passed into each renal artery delivers short bursts of radiofrequency or ultrasound energy to the artery wall, interrupting the nerve traffic. It is not a cure for hypertension and it does not replace tablets, but it shifts the whole 24-hour pressure profile down by a useful amount.
Who It Is For
Renal denervation is considered for genuine resistant hypertension — and confirming that it is genuine is half the work:
- Blood pressure still above target despite three or more medications, including a diuretic, at proper doses
- Raised readings confirmed on 24-hour ambulatory monitoring, not just in the clinic
- Treatable secondary causes — such as a hormone-producing adrenal tumour or sleep apnoea — already looked for and excluded
- Renal arteries of a suitable size and shape on a CT scan
- Also an option for someone who genuinely cannot tolerate blood pressure medication
What the Evidence Shows
The sham-controlled trials — SPYRAL HTN and RADIANCE-HTN — show renal denervation lowers 24-hour systolic pressure by roughly 4 to 10 mmHg on average, an effect that is present day and night and appears durable over several years. That is a modest but worthwhile shift: a sustained 5 mmHg reduction meaningfully lowers the long-term risk of stroke and heart attack. Response varies between individuals, and some people respond much more than the average.
The Procedure and After
It is a day case under local anaesthetic with sedation, via a puncture in the groin. Both renal arteries are treated in one session of about an hour, and you go home the same day, resting the leg overnight. Blood pressure does not drop immediately — it drifts down over weeks to months as the nerves fall silent. Dr. Chang keeps you on your current tablets initially and uses ambulatory monitoring at three and six months to measure the effect and carefully reduce medication where the numbers allow.
Renal Denervation: Common Questions
Considering Renal Denervation?
Dr. Peter Chang will assess your suitability and discuss all treatment options during a specialist consultation at Paragon Medical Centre, Singapore.