Renal denervation

Hypertension
Hypertension or high blood pressure is a major risk factor for stroke, heart attack and peripheral vascular disease. It is also one of the most important causes of chronic kidney failure. At present it is estimated that there are almost 1 billion people worldwide with hypertension, the majority in the established market economies. It is believed however that by 2025 there will be 1.5 billion patients with hypertension globally with three quarters coming from the developing world.

Usual treatment of hypertension
Usual treatments for hypertension include lifestyle measures and taking blood pressure lowering medicines. The former include increasing levels of physical activity, weight loss and restricting salt intake. It is also important to moderate alcohol intake to < 14 u per week in women and < 21 units per week in men. There are many different kinds of anti-hypertensive drugs available for treatment and it is widely accepted now that most patients will need 2-3 drugs to control their blood pressure in addition to observing lifestyle measures.

New treatment for hypertension
The Harley Street Clinic is the first private hospital in the UK to offer a new treatment to lower blood pressure using a technique called renal denervation which is now available to patients with difficult hypertension. This involves passing a fine tube or catheter into the femoral artery in the groin and tracing it back to the arteries supplying the kidneys. The catheter is advanced into each kidney artery in turn and deployed to pass a low energy current at several points along the artery which leads to inactivation of the nerves supplying the kidneys. This results in interruption of important signals that cause high blood pressure and subsequent lowering of blood pressure which starts within weeks after the therapy. The treatment takes about 40 minutes in total and requires an overnight stay in the hospital.

A landmark clinical trial has was published in the prestigious medical journal The Lancet (in December 2010) demonstrating that renal denervation is both highly effective and very safe with average BP lowering of 32/12 mm Hg in treated patients at 6 months after treatment.

What are the side effects of treatment with renal denervation?
To date there have been no serious complications in any of the patients treated with renal denervation worldwide. The commonest problems which only occur in a minority of patients include bruising/discomfort in the groin/leg following the procedure. There is no evidence that the procedure causes any problems with kidney function.

Is renal denervation the right treatment for me?
At present this technique is available to those patients with difficult or resistant hypertension whose BP control is poor despite being on several anti-hypertensive agents or for those patients who are having difficulty tolerating their anti-hypertensive drugs. Suitable candidates will have been thoroughly screened by a Hypertension Specialist to ensure no identifiable cause of hypertension has been missed (such as adrenal gland problems) and that their treatment with tablets has been optimised. Patients need to have scanning tests to look at the kidney arteries (CT renal angiography) in order to determine that the artery is anatomically suitable for treatment.

Appointments
To make an appointment to discuss this service, please contact HCA Connect on 020 7079 4344.