Renal Denervation and Nephrologist's Role

Abstract

Recent clinical trials have shown that catheter based bilateral sympathetic renal denervation can significantly reduce blood pressure values in resistant hypertensive patients. In addition to this blood pressure lowering effect this procedure determines a significant reduction of the sympathetic activity, of insulin resistance and of cardio-renal target organ damage. Catheter based renal denervation is a safe procedure with very limited side effects. Although the clinical evidence obtained from recent clinical trials showing that renal denervation can significantly reduce blood pressure values in resistant hypertensive patients is solid, it is important to test this procedure in the real clinical setting. This is the principal aim of the Italian Registry which will collect data on the efficacy and safety of this procedure in the short and long term. However, the effects of the procedure on the renal function, proteinuria and sodium balance are still not well known in particular in the long term. These informations are required in order to extend the indications of the renal denervation in different pathological conditions characterized by elevated sympathetic nervous activity, and to establish the cost-effectiveness of this procedure as a potential alternative as compared to the traditional pharmacological treatments.