Catheter-based renal denervation (RDN) therapy, a new procedure that uses radiofrequency ablation to interrupt efferent and afferent renal sympathetic nerve fibers, is a complementary or alternative treatment to antihypertensive medications for optimal control of blood pressure (BP). Although several single-arm early proof-of-concept studies showed significant BP reduction, the largest sham-controlled study using the first-generation RDN device (SYMPLICITY HTN-3) failed to significantly reduce BP in patients with resistant hypertension who were taking the guideline-based combination of antihypertensive medications. Since then, new devices and techniques have been developed to improve the efficacy and safety of RDN procedures. Sham-controlled trials using second-generation RDN devices (radiofrequency- and ultrasound-based) have provided solid evidence for their BP-lowering efficacy with and without the use of concomitant antihypertensive medication. Moreover, the safety profile of RDN in several registries and clinical trials appears to be excellent. This review summarizes the current evidence for RDN and discusses its current issues, future trials, Asian perspectives, and potential roles in both hypertension and other morbidities.

中文翻译：

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肾去神经支配的现状和未来展望。

基于导管的肾去神经支配 (RDN) 疗法是一种使用射频消融来中断传入和传入肾交感神经纤维的新程序，是抗高血压药物的补充或替代疗法，可优化控制血压 (BP)。尽管几项单臂早期概念验证研究显示血压显着降低，但使用第一代 RDN 装置（SYMPLICITY HTN-3）的最大假对照研究未能显着降低服用该药的顽固性高血压患者的血压。基于指南的抗高血压药物组合。从那时起，开发了新的设备和技术来提高 RDN 程序的有效性和安全性。使用第二代 RDN 设备（基于射频和超声）的假对照试验为它们在使用和不使用伴随抗高血压药物的情况下降低血压的功效提供了确凿的证据。此外，RDN 在多个注册和临床试验中的安全性似乎非常好。本综述总结了 RDN 的当前证据，并讨论了其当前问题、未来试验、亚洲观点以及在高血压和其他疾病中的潜在作用。