Dr Simon Kennon MB ChB, FRCP, MD Consultant Cardiologist

Renal Artery Denervation

Unfortunately, in about half of all treated patients, lifestyle changes and medications are not enough to control high blood pressure. For this group, renal artery denervation is an option. This procedure can selectively calm hyperactive renal nerves which causes a reduction in the kidneys’ production of hormones that raise blood pressure.

The procedure

Renal Artery Denervation (RDN) is performed under local anesthetic by inserting a catheter into an artery in the groin through a small incision and feeding the catheter into the renal arteries which supply blood and nervous stimulation to the kidneys.

X-rays are used to allow visualisation of the catheter within the blood vessels and aid in positioning it correctly. An electric current is then passed through the catheter which heats the wall of the artery and leads to destruction of the nerves within and outside the wall. This in turn results in reduced stimulation to physiological mechanisms in the kidneys which are felt to be responsible for causing hypertension.

It also reduces nerve signals from the kidneys to the brain which are also involved in development of high blood pressure. The catheter is then removed from the groin and any bleeding prevented by firm pressure to the area for several minutes. The procedure takes approximately 40 minutes to perform.

Risks

Complications from RDN therapy are very low, but as with all diagnositic procedures involving catheterisation of the arteries, there are potential risks such as damage to the arteries, blood clots, blood pressure changes and cardiac arrest. Other risks include kidney damage, pain and infection, skin burn, blood or protein in urine and electrolyte changes.

Recovery

Many patients are able to go home and return to work or their normal daily routines, very soon after the procedure. The amount of time that you stay in the hospital will depend on several factors including how well your puncture wound is healing.