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New procedure for lowering blood pressure: Renal denervation inspires experts!
On World Hypertension Day 2025, Medical Clinic 4 at the University of Erlangen-Nuremberg will highlight innovative approaches to treating high blood pressure.
New procedure for lowering blood pressure: Renal denervation inspires experts!
On May 17, 2025, on the occasion of World Hypertension Day, the Medical Clinic 4 of the Erlangen University Hospital will focus on the topic of high blood pressure, especially in dialysis patients. In Germany, around 90,000 people are dependent on dialysis, and many of them are affected by high blood pressure. The use of the renal denervation (RDN) could be crucial to reduce blood pressure and cardiovascular risk in these patients. The first treatments with RDN have already begun, and the clinical team led by Dr. Dennis Kannenkeril is looking for additional participants for a planned follow-up study.
High blood pressure, along with diabetes, is one of the most common causes of need for dialysis. During the treatment of a 22-year-old dialysis patient, Tatevik G., it was observed that significant spikes in blood pressure occurred despite taking antihypertensive medication. In December 2024, she underwent RDN, which lowered her blood pressure by 10 to 20 mmHg. Normal blood pressure is considered to be around 120/80 mmHg, while values above 140/90 mmHg should be treated.
Application of renal denervation
Renal denervation is a modern, minimally invasive procedure for the treatment of high blood pressure that has been carried out using the catheter-assisted method since 2010. The procedure aims to reduce the activity of the sympathetic nerve fibers around the kidneys. This is done through a catheter that is passed through the groin or wrist artery to the renal arteries, where overactive nerves are destroyed. The procedure takes around 40 to 60 minutes and is carried out under local anesthesia. During this time the patient is awake and possible short-term pain is treated with pain medication.
Positive results have been achieved in clinical trials when performing RDN. According to a 2019 pilot study, systolic blood pressure was reduced by an average of 20 mmHg. Around 75% of patients show a significant reduction in blood pressure after the procedure, which lasts for at least 36 months. The procedure is considered low-risk, comparable to a cardiac catheter examination, and requires an interdisciplinary assessment before treatment.
Prerequisites and follow-up treatment
There are specific patient criteria for RDN: There must be treatment-resistant high blood pressure that cannot be controlled despite at least three antihypertensive medications. In addition, secondary causes must be excluded and renal function should be within an acceptable range (eGFR above 45 ml/min/1.73 m²). The Erlangen University Hospital has been certified as a center for renal denervation since 2022 and offers qualified aftercare. This includes regular follow-up examinations in the first year to check the success of the treatment and any adjustments to the medication.
In summary, renal denervation represents a promising form of therapy for dialysis patients with treatment-resistant hypertension. Since high blood pressure often leads to cardiovascular complications in the population, further studies and the targeted search for test subjects like them are necessary FAU underlines, is of great importance for medical research and patient care. Experts are also calling for an expansion of therapy options and the certification of qualified centers in Germany.