Keywords
Refractory Hypertension
Safety
Efficacy
How to Cite
Abstract
This article aims to perform a systematic review of the current medical literature on Renal Denervation in the context of Refractory Hypertension. The Virtual Health Library database was used as search engines, with inclusion and exclusion criteria pre-established by the authors. The descriptors used were "refractory hypertension and renal denervation". It is concluded that renal denervation is a viable option for the treatment of refractory hypertension, in addition to bringing benefits to other conditions, such as sleep apnea and paroxysmal atrial fibrillation by improving diastolic ejection fraction. However, the authors request new clinical trials, with a larger number of patients and observation period, in order to ensure the safety and efficacy of the procedure.
References
ALBERTINO, S. et al. Denervação de artéria renal em paciente com hipertensão arterial refratária. Revista Brasileira de Hipertensão. 2022. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/biblio-1517577. Acesso em: 26 de janeiro de 2025.
BARBOSA, D.F. et al. Denervação renal: tratamento alternativo para a hipertensão resistente grave. Brazilian Journal of Health and Biological Science, v. 1, n. 2, p. 01-13, 2024.Disponível em: https://bjhbs.com.br/index.php/bjhbs/article/view/79. Acesso em: 26 de janeiro de 2025.
BUSO, G. et al. The Global Burden of Resistant Hypertension and Potential Treatment Options. European cardiology. 2024. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-38983582. Acesso em: 26 de janeiro de 2025.
CAI, H. et al. Efficacy and safety of 3D reconstruction and basket multi-electrode renal denervation (RDN) for refractory hypertensive patients with chronic kidney disease. The Journal of Clinical Hypertension (Greenwich). 2024. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-38430475. Acesso em: 26 de janeiro de 2025.
CAI, H. et al. Insight on Efficacy of Renal Artery Denervation for Refractory Hypertension with Chronic Kidney Diseases: A Long-Term Follow-Up of 24-Hour Ambulatory Blood Pressure. Journal of Interventional Cardiology. 2022. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-36212674. Acesso em: 26 de janeiro de 2025.
DE ALMEIDA MAIA, H.C. et al. Denervação simpática renal por radiofrequência em pacientes com hipertensão arterial sistêmica resistente ao tratamento medicamentoso. Disponível em: http://sociedades.cardiol.br/co/revista_arco/2011/Revista05/06-revisao-denervacao.pdf. Acesso em: 26 de janeiro de 2025.
DOUMAS, M. et al. Recent advances in understanding and managing resistant/refractory hypertension. F1000 Research. 2020. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-32201574. Acesso em: 26 de janeiro de 2025.
FALKOVSKAYA, A. et al. Refractory and Resistant Hypertension in Patients with Type 2 Diabetes Mellitus: Different Response to Renal Denervation. Kardiologiia. 2021. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-33734049. Acesso em: 26 de janeiro de 2025.
FILIPPONE, E.; NACCARELLI, V.; FOY, J. Controversies in Hypertension V: Resistant and Refractory Hypertension. The American Journal of Medicine. 2024. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-37832756.Acesso em: 26 de janeiro de 2025.
KARIO, K. et al. Obstructive Sleep Apnea-Induced Neurogenic Nocturnal Hypertension: A Potential Role of Renal Denervation? Hypertension. 2021. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-33641363. Acesso em: 26 de janeiro de 2025.
LIMA, F.T. et al. Denervação simpática renal no tratamento da hipertensão arterial resistente: relato de caso. Revista Brasileira de Hipertensão, v. 29, n. 3 p. 69-73, 2022. Disponível em: http://departamentos.cardiol.br/sbc-dha/profissional/revista/29-3/04_revista%20brasileira%20de%20hipertens%C3%A3o_29_n3.pdf. Acesso em: 26 de janeiro de 2025.
LI, L. Effect of renal denervation for patients with isolated systolic hypertension: a systematic review and meta-analysis. Journal of Geriatric Cardiology. 2023. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-36910242. Acesso em: 26 de janeiro de 2025.
MANTANES, F. et al. An Update on Refractory Hypertension. Current Hypertension Reports. 2022. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-35384577. Acesso em: 26 de janeiro de 2025.
OBI, M. et al. The Implementation of Renal Denervation in the Management of Resistant Hypertension Despite Use of Multitherapy Antihypertensives at Maximally Tolerated Doses: A Contemporary Literature Review. Cureus. 2023. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-37559838. Acesso em: 26 de janeiro de 2025.
OLIVEIRA, R.L.B. et al. Denervação simpática renal como tratamento da hipertensão arterial sistêmica secundária. Brazilian Journal of Health Review, v. 6, n. 5, p. 23151-23160, 2023. Disponível em: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/63440. cesso em: 26 de janeiro de 2025.
PILCH, J. et al. Native Renal Arteries Denervation as a Therapy of Refractory Hypertension in Patient after Heart and Kidney Transplantation-5 Years of Observation. Journal of Clinical Medicine. 2023. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-37685525. Acesso em 24 de dezembro de 2025.
ROSIER, S. et al. Robot-assisted renal denervation as a new surgical approach for therapy resistant arterial hypertension. Urology Case Reports. 2024. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-39310116. Acesso em 24 de dezembro de 2025.
RUILOPE, L. et al. Resistant hypertension: new insights and therapeutic perspectives. European Heart Journal - Cardiovascular Pharmacotherapy. 2020. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-31598644. Acesso em: 26 de janeiro de 2025.
SU, F. et al. Refractory hypertension with type 2 diabetes treated with endovascular denervation combined with renal sympathetic denervation under three-dimensional guidance: a case report. Jornal Chinês de Doenças Refratárias. 2025. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-39143785. Acesso em: 26 de janeiro de 2025.
WANG, L. et al. Effect of RDN on long-term blood pressure in refractory hypertensive patients with different cardiovascular risk stratification. Jornal Chinês de Doenças Refratárias. 2025. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-39143781.Acesso em: 26 de janeiro de 2025.
XU, H. et al. The Effect of Renal Denervation on Cardiac Diastolic Function in Patients with Hypertension and Paroxysmal Atrial Fibrillation. Evidence-Based Complementary and Alternative Medicine. 2022. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-35668773. Acesso em: 26 de janeiro de 2025.
ZHANG, H. et al. Clinical Effect of Renal Arterial Sympathetic Radiofrequency Ablation on Secondary Hypertension. Computational and Mathematical Methods in Medicine. 2022. Disponível em: https://pesquisa.bvsalud.org/portal/resource/es/mdl-35959345. Acesso em: 26 de janeiro de 2025.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2025 Pedro Henrique Rogério De Lima, Ana Beatriz Vasconcelos Da Silva, Gabriel Almeida Lisbôa Oliveira, Helena Gabriela Nascimento Dos Santos, Cledson dos Reis Araújo, Inggryd Eduarda Possidônio de Souza Santos, Yan Caio Mendes Amaral
