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ESH Position Paper: Renal denervation – an interventional therapy of resistant hypertension

Schmieder, Roland E.a; Redon, Josepb; Grassi, Guidoc,k; Kjeldsen, Sverre E.d; Mancia, Giuseppee; Narkiewicz, Krzysztoff; Parati, Gianfrancog; Ruilope, Luish; van de Borne, Philippei; Tsioufis, Costasj

doi: 10.1097/HJH.0b013e328352ce78

Experts from the European Society of Hypertension prepared this position paper in order to summarize current evidence, unmet needs and practical recommendations on the application of percutaneous transluminal ablation of renal nerves [renal denervation (RDN)] as a novel therapeutic strategy for the treatment of resistant hypertension. The sympathetic nervous activation to the kidney and the sensory afferent signals to the central nervous system represent the targets of RND. Clinical studies have documented that catheter-based RDN decreases both efferent sympathetic and afferent sensory nerve traffic leading to clinically meaningful systolic and diastolic blood pressure (BP) reductions in patients with resistant hypertension. This position statement intends to facilitate a better understanding of the effectiveness, safety, limitations and issues still to be addressed with RDN.

aUniversity Hospital Erlangen, Nephrology and Hypertension, Erlangen, Germany

bUniversity of Valencia, Internal Medicine, Hypertension Unit, Valencia, Spain

cClinica Medica, Ospedale S. Gerardo dei Tintori, Monza (Milan), Italy

dUniversity of Oslo, Department of Cardiology at Ullevaal Hospital, Oslo, Norway

eUniversity of Milano-Bicocca, Department of Medicine, S. Gerardo Hospital, Monza, Italy

fMedical University of Gdansk, Department of Hypertension and Diabetology, Gdansk, Poland

gDepartment of Cardiology, S.Luca Hospital, Istituto Auxologico Italiano & Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milan, Italy

hUniversity Autonoma & Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain

iDepartment of Cardiology, Erasme Hospital, Brussels, Belgium

jUniversity of Athens, First Cardiology Clinic, Hippokration Hospital, Athens, Greece

kIstituto di Ricerche a Carattere Ccientifico IRCCS Multimedica, Sesto san Giovanni (Milan), Italy

Correspondence to Roland E. Schmieder, University Hospital Erlangen, Nephrology and Hypertension, Ulmenweg 18, 91054 Erlangen, Germany.Tel: +49 9131 8536245; fax: +49 9131 8536215; e-mail:

Abbreviations: BP, blood pressure; RDN, renal denervation

Received 1 February, 2012

Revised 21 February, 2012

Accepted 21 February, 2012

© 2012 Lippincott Williams & Wilkins, Inc.