{"id":33730,"date":"2012-12-20T07:06:07","date_gmt":"2012-12-20T12:06:07","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=interventional&p=33730"},"modified":"2012-12-20T07:06:07","modified_gmt":"2012-12-20T12:06:07","slug":"is-zapping-the-kidneys-miraculous","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/12\/20\/is-zapping-the-kidneys-miraculous\/","title":{"rendered":"Is \u201cZapping the Kidneys\u201d Miraculous?"},"content":{"rendered":"

\u00a0Fact or fiction? \u00a0<\/em><\/strong>According to the latest lay press, renal denervation is \u201ca potential public health miracle,\u201d and \u201czapping the kidneys with radio waves can safely and dramatically lower blood pressure . . . Reduction in heart attacks and stroke rates of more than 40 per cent is anticipated.\u201d<\/p>\n

The facts: <\/em><\/strong>\u00a0In patients with drug-resistant hypertension (HTN), renal denervation with the use of the Symplicity catheter system (Medtronic Vascular) results in sustained blood pressure reductions. Systolic blood pressure reductions of 25 to 30 mm Hg were durable when follow-up was extended to 2 years in the open label Symplicity HTN-1<\/a> study and\u00a0to 1\u00a0year in the randomized Symplicity HTN-2<\/a> study.<\/p>\n

The future: \u00a0<\/em><\/strong>In March 2013, a phase 3, multicenter (87 sites), prospective, single-blind, randomized, controlled study (Symplicity HTN-3<\/a>) of the safety and efficacy of renal denervation in 530 subjects with uncontrolled\u00a0HTN\u00a0is expected to\u00a0be completed. <\/em><\/strong><\/p>\n

In addition, studies of renal denervation (using the Symplicity catheter system) for treatment of the following conditions is underway:<\/p>\n

    \n
  1. Resistant HTN in India,* Germany, Czech Republic, France, Belgium, Norway<\/li>\n
  2. Mild refractory HTN<\/li>\n
  3. Resistant HTN in chronic kidney disease (Singapore)<\/li>\n
  4. Resistant HTN and sleep apnea (Poland)<\/li>\n
  5. Resistant HTN and metabolic syndrome<\/li>\n
  6. Chronic heart failure (with* and without renal impairment)<\/li>\n
  7. Diabetic nephropathy<\/li>\n<\/ol>\n

    * indicates industry sponsored studies.<\/em><\/p>\n

    Your thoughts:<\/strong><\/em><\/p>\n

    Are you convinced of\u00a0renal denervation’s\u00a0safety and efficacy?<\/strong><\/em><\/p>\n

    Would you refer your patients with resistant HTN for this procedure, or do you need more data?<\/em><\/strong><\/p>\n

    Do you plan to perform renal denervation?<\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

    Renal denervation for resistant hypertension is generating a lot of excitement. In this blog, Rick Lange and David Hillis take stock of the evidence and the efforts underway to explore the potential scope of indications for the procedure.<\/p>\n","protected":false},"author":214,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9,7,16],"tags":[581,921,580],"class_list":["post-33730","post","type-post","status-publish","format-standard","hentry","category-interventional-cardiology","category-prevention","category-vascular","tag-renal-denervation","tag-resistant-hypertension","tag-symplicity-htn-2"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/33730","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/214"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=33730"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/33730\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=33730"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=33730"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=33730"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}