December 20th, 2012
Is “Zapping the Kidneys” Miraculous?
Fact or fiction? According to the latest lay press, renal denervation is “a potential public health miracle,” and “zapping the kidneys with radio waves can safely and dramatically lower blood pressure . . . Reduction in heart attacks and stroke rates of more than 40 per cent is anticipated.”
The facts: In patients with drug-resistant hypertension (HTN), renal denervation with the use of the Symplicity catheter system (Medtronic Vascular) results in sustained blood pressure reductions. Systolic blood pressure reductions of 25 to 30 mm Hg were durable when follow-up was extended to 2 years in the open label Symplicity HTN-1 study and to 1 year in the randomized Symplicity HTN-2 study.
The future: In March 2013, a phase 3, multicenter (87 sites), prospective, single-blind, randomized, controlled study (Symplicity HTN-3) of the safety and efficacy of renal denervation in 530 subjects with uncontrolled HTN is expected to be completed.
In addition, studies of renal denervation (using the Symplicity catheter system) for treatment of the following conditions is underway:
- Resistant HTN in India,* Germany, Czech Republic, France, Belgium, Norway
- Mild refractory HTN
- Resistant HTN in chronic kidney disease (Singapore)
- Resistant HTN and sleep apnea (Poland)
- Resistant HTN and metabolic syndrome
- Chronic heart failure (with* and without renal impairment)
- Diabetic nephropathy
* indicates industry sponsored studies.
Are you convinced of renal denervation’s safety and efficacy?
Would you refer your patients with resistant HTN for this procedure, or do you need more data?
Do you plan to perform renal denervation?