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Renal denervation: one step backwards, three steps forward

Nature Reviews Nephrology (2018) | Download Citation

Many considered the failure of the SYMPLICITY HTN-3 trial to represent the end of therapeutic renal denervation. However, promising preliminary data from the SPYRAL HTN-OFF MED study and more recently the SPYRAL HTN-ON MED and RADIANCE-HTN SOLO studies support the efficacy of this intervention for blood pressure lowering in patients with hypertension.

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  1. 1.

    Townsend, R. R. et al. Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF MED): a randomised, sham-controlled, proof-of-concept trial. Lancet 390, 2160–2170 (2017).

  2. 2.

    Kandzari, D. E. et al. Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial. Lancet 391, 2346–2355 (2018).

  3. 3.

    Azizi, M. et al. Endovascular ultrasound renal denervation to treat hypertension (RADIANCE-HTN SOLO): a multicentre, international, single-blind, randomised, sham-controlled trial. Lancet 391, 2335–2345 (2018).

  4. 4.

    Krum, H. et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet 373, 1275–1281 (2009).

  5. 5.

    Esler, M. D. et al. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet 376, 1903–1909 (2010).

  6. 6.

    Krum, H. et al. Percutaneous renal denervation in patients with treatment-resistant hypertension: final 3-year report of the Symplicity HTN-1 study. Lancet 383, 622–629 (2014).

  7. 7.

    Esler, M. D. et al. Catheter-based renal denervation for treatment of patients with treatment-resistant hypertension: 36 month results from the SYMPLICITY HTN-2 randomized clinical trial. Eur. Heart J. 35, 1752–1759 (2014).

  8. 8.

    Mahfoud, F. et al. Effect of renal denervation on left ventricular mass and function in patients with resistant hypertension: data from a multi-centre cardiovascular magnetic resonance imaging trial. Eur. Heart J. 35, 2224–2231 (2014).

  9. 9.

    Bhatt, D. L. et al. A controlled trial of renal denervation for resistant hypertension. N. Engl. J. Med. 370, 1393–1401 (2014).

  10. 10.

    Mahfoud, F. et al. Impact of lesion placement on efficacy and safety of catheter-based radiofrequency renal denervation. J. Am. Coll. Cardiol. 66, 1766–1775 (2015).

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Author information


  1. Dobney Hypertension Centre, School of Medicine — Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia

    • Markus P. Schlaich
  2. Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, Western Australia, Australia

    • Markus P. Schlaich
  3. Neurovascular Hypertension & Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia

    • Markus P. Schlaich
  4. Comprehensive Hypertension Center, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA

    • George L. Bakris


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Competing interests

M.P.S. is supported by a National Health and Medical Research Council (NHMRC) Research Fellowship and has received consulting fees and/or travel and research support from Medtronic, Abbott, Novartis, Servier, Pfizer and Boehringer-Ingelheim. G.L.B. has acted as Consultant for Merck, Relypsa, Vascular Dynamics, Medtronic and Bayer, and has been involved in clinical trials: FIDELIO-Bayer-Principal Investigator, CREDENCE-Steering Committee and CALM-2-Executive Committee.

Corresponding author

Correspondence to Markus P. Schlaich.

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