September 3rd, 2013

Renal Denervation: The Next Magic Bullet?

Several Cardiology Fellows who are attending ESC.13 in Amsterdam this week are blogging for CardioExchange. The Fellows include Paddy BarrettLouis Handoko, and  Amanda Vest. For more of our ESC.13 coverage of late-breaking clinical trials, interviews with the authors of the most important research, and blogs from our fellows on the most interesting presentations at the meeting, check out our Coverage Headquarters.

For scientific reasons, my attention has recently been drawn to renal denervation. In a landmark paper, the Symplicity HTN-1 study group demonstrated impressive and sustained effects of this procedure on blood pressure reduction in patients with therapy-resistant hypertension. Their findings have been confirmed repeatedly by others. Renal denervation is a relative simple procedure, which has assisted in establishing this novel treatment modality. Just recently, my own institute started to use renal denervation, and the experiences are positive so far.

Soon after that paper was published, pilot studies demonstrated beneficial effects for other indications. These were the main subject of the session I attended this morning. Based on the data provided, I got the impression that renal denervation is the solution for everything. Beside hypertension, it also treats diabetes, acute and chronic heart failure, worsening of renal function, as well as obstructive sleep apnea…. Although these developments are very interesting and exciting, they also sounded too good to be true. And, there must be a reason that we are born with a sympathetic brain-kidney connection….

Fortunately, almost every presenter announced a full-scale, investigator-driven, randomized clinical trial on the specific topic, and hopefully in the near future, these trials will provide more-definite answers on the role of renal denervation. I intend to follow these developments closely. New data at the 2014 ESC meeting? You and I will see in Barcelona next year!

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