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Renal Denervation Resistant Hypertension — ESENeph MCQ

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HardHypertensionRenal Denervation Resistant HypertensionESENeph

A 55-year-old man with resistant hypertension and CKD G3a asks about renal denervation as an alternative to adding more medications. What is the current evidence status?

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Correct answer: E — Renal denervation has shown modest BP-lowering effects in sham-controlled trials (SPYRAL HTN-ON, RADIANCE-HTN); it is not yet part of routine practice but may be considered in highly selected patients with true resistant hypertension who cannot tolerate medications

Renal denervation (catheter-based ablation of renal sympathetic nerves) has shown modest but significant BP reductions in sham-controlled trials (SPYRAL HTN-ON MED, RADIANCE-HTN TRIO). Average SBP reduction is approximately 5-10 mmHg versus sham. It is not yet recommended as routine therapy but may be considered for highly selected patients with true resistant hypertension who cannot tolerate adequate medication. NICE and ESC have not yet incorporated it into standard guidelines. CKD-specific data is limited.

Reference: SPYRAL HTN-ON MED – Lancet 2018; RADIANCE-HTN TRIO – Lancet 2021