Transurethral renal denervation – a new method of uncontrolled HT treatment
10.08.2023
Results of long-term research of Prof. Dagmara Hering from the Department of Hypertension & Diabetology of the Medical University of Gdańsk obtained the consent of the Food and Drug Administration, an American government institution, to start the so-called pivotal clinical trial in hypertension. Scientific works in the field of transurethral renal denervation were carried out by Prof. Hering under prestigious scholarships of the Kościuszko Foundation and the Senior Award Fulbright at Arizona State University.
Transurethral renal denervation is a minimally invasive method of treating hypertension (HT). It is estimated that more than 30% of the adult population (including Poland) have HT, of which only half have been diagnosed with the disease. Among people diagnosed with hypertension, only 50% are treated and only 25% has good blood pressure control. Therefore, surgical methods are sought to ensure safe and effective control of hypertension.
Using the VERVE Medical system, developed by a team of researchers at Arizona State University, the first extravascular methods of effective kidney denervation became possible.
– This method enables the nerve fibers of the kidneys located in the renal pelvis to be denervated, as a result of which the sympathetic activity involved in the development of hypertension is reduced – explains Prof. Dagmara Hering. – _Unlike previous transvascular methods, such as inserting a catheter directly into the renal arteries and performing radiofrequency, ultrasound or alcohol ablation, transurethral renal denervation leads to an immediate reduction in blood pressure already during the procedure.
The innovative method enables the visualization of the inserted catheter through a natural opening of the body, the so-called urethra for kidney denervation, without the need for contrast. Importantly, it can be performed in patients regardless of the anatomy and atherosclerosis of the renal arteries, due to which 30-50% of patients suffer from renal failure do not qualify for renal artery denervation or do not respond to surgical treatment.
– The obtained results indicate that transurethral renal denervation is a safe method, leads to an immediate reduction in blood pressure, significantly improves kidney function (increase in eGFR) and this effect is maintained in the one-year follow-up without the need to add antihypertensive drugs – adds Prof. Hering.
It should be emphasized that every second hypertensive patient stops taking antihypertensive drugs after a year from their inclusion, and kidney denervation ensures a 24-hour hypotensive effect, which is independent of the use of antihypertensive drugs.
This method is not yet widely available, and a multicentre randomized trial in the United States is now needed before transurethral renal denervation can be used in clinical practice.
photo Paweł Sudara/MUG