What is a denervation procedure?

Is renal denervation effective?

Increasing studies strongly prove that renal denervation, a minimally invasive surgery, is a promising new non-drug treatment method that can effectively control blood pressure in patients with resistant hypertension, but the evaluation of the long-term blood pressure control effect of renal denervation for resistant ...

What is hypertension resistant?

Resistant hypertension is high blood pressure that does not respond well to aggressive medical treatment. Hypertension is considered resistant when all of the following are true: Someone is taking three* different blood pressure medications at their maximally tolerated doses.

What are the causes of renal artery stenosis?

Is renal artery stenosis fatal?

Renal artery stenosis due to fibromuscular dysplasia is a potentially fatal condition, and may result in end-stage renal failure.

What is the most common clinical symptom of renal artery stenosis?

The kidneys play an important role in regulating blood pressure by secreting a hormone called renin. If the renal arteries are narrowed or blocked, the kidneys cannot work effectively to control blood pressure. Persistent or severe high blood pressure is a common symptom of renal artery stenosis.

Which medication should be avoided in patients with renal stenosis?

These are called ACE inhibitors and have names ending in -opril. Examples are captopril (also called 'Captopen'), lisinopril (also called 'Zestril'), ramipril, fosinopril. These are to be avoided because they can cause kidney failure in renal artery stenosis.

How do you deal with resistant hypertension?

Treatment of resistant hypertension is focused on the addition of fourth-line therapy where blood pressure is not controlled by treatment with three drugs, described by NICE as A+C+D: that is, an ACE inhibitor or an angiotensin II receptor blocker (A), a calcium channel antagonist (C), and a thiazide or thiazide-like ...

How common is resistant hypertension?

Resistant hypertension, defined as failure to achieve goal blood pressures in patients taking optimal or maximum tolerated doses of three or more antihypertensive drugs, is estimated to occur in about 25% of hypertensive patients on treatment.

What causes high blood pressure that won't go down?

The accumulation of artery-clogging plaque in blood vessels that nourish the kidneys, a condition called renal artery stenosis. Sleep problems, such as the breath-holding type of snoring known as obstructive sleep apnea. Obesity or heavy intake of alcohol or other substances that can interfere with blood pressure.

Can only one kidney fail?

Since most people have two kidneys, both kidneys must be damaged for complete kidney failure to occur. Fortunately, if only one kidney fails or is diseased it can be removed, and the remaining kidney may continue to have normal kidney (renal) function.

Is kidney disease a renal disease?

End-stage renal disease, also called end-stage kidney disease or kidney failure, occurs when chronic kidney disease — the gradual loss of kidney function — reaches an advanced state. In end-stage renal disease, your kidneys no longer work as they should to meet your body's needs.

What is refractory hypertension?

Refractory hypertension is defined as uncontrolled blood pressure despite use of ≥5 antihypertensive agents of different classes, including a long-acting thiazide-like diuretic and an MR (mineralocorticoid receptor) antagonist, at maximal or maximally tolerated doses.

What is the most common cause of resistant hypertension?

Most common secondary causes of resistant hypertension are obstructive sleep apnea, renal artery stenosis, renal parenchymal disease, and primary aldosteronism while some uncommon causes such as pheochromocytoma, Cushing's disease, thyroid and parathyroid dysfunction; and aortic coarctation also contribute to resistant ...

Why is my blood pressure not responding to medication?

With complicated dosing schedules, people can forget to take medications or not take the correct doses at the correct times. Also, other drugs can interfere with blood pressure control, including pain relievers (NSAIDs), oral contraceptives and nasal decongestants.

How is resistant hypertension diagnosed?

The diagnosis of resistant hypertension requires use of good blood pressure technique to confirm persistently elevated blood pressure levels. Pseudoresistance, including lack of blood pressure control secondary to poor medication adherence or white coat hypertension, must be excluded.

What drug is used for resistant hypertension?

The most common classes of blood pressure medicines are diuretics, calcium channel blockers, and ACE inhibitors/angiotensin receptor blockers (ARBs). Studies have shown that use of the diuretic chlorthalidone is very effective in treating hypertension.

What are the complications of uncontrolled hypertension?

When do you stent renal artery stenosis?

In my opinion, there is a certain group of patients who have serum creatinine of >2.5 to 3 mg/dL, severe bilateral disease, or documented significant diminution in the length of the kidneys who exhibit rapidly progressing renal dysfunction due to a renal artery stenosis that has a gradient across it that should to be ...

Is renal artery stenosis painful?

Stenosis of one renal artery is often asymptomatic for a considerable time. Acute complete occlusion of one or both renal arteries causes steady and aching flank pain, abdominal pain, fever, nausea, and vomiting.

Can you reverse renal artery stenosis?

Treatment for renal artery stenosis may involve lifestyle changes, medication and a procedure to restore blood flow to the kidneys. Sometimes a combination of treatments is the best approach. Depending on your overall health and symptoms, you may not need any specific treatment.