Renal Denervation

Renal denervation is a minimally invasive procedure for some people with high blood pressure. Using ultrasound or radiofrequency energy, the procedure damages certain nerves near your kidneys. This keeps the nerves from sending signals to raise your blood pressure. A healthcare provider uses a catheter (small tube) to send energy through renal artery walls and reach the nerves.

This procedure can help people who have high blood pressure that isn’t getting better with several medicines and lifestyle changes. People may have resistant hypertension or just aren’t able to take certain drugs because of side effects.

You need to have healthy kidneys (and arteries that connect to them) to get this procedure. Your renal arteries need to be wide enough and in good shape for this treatment.

The U.S. Food and Drug Administration approved this procedure in 2023.

Preparing for renal denervation

Before the procedure, your healthcare provider may want to do blood tests to make sure your kidneys work well. They may also do imaging tests. Ask your healthcare team if you should stop eating and drinking at a certain time before the procedure. They can also tell you if (and when) you need to stop taking any medicines before renal denervation.

Also, you should arrange for someone to come with you and drive you home. On the day of the renal denervation procedure, it can be helpful to wear clothes and shoes that are easy to get back into before you go home.

What happens during this procedure?

A renal denervation procedure takes about one to two hours. Healthcare providers usually perform the procedure on nerves for both kidneys.

A healthcare provider will:

1. Give you sedation to relax you and pain medicine so you won’t feel pain
2. Make a small poke in your groin
3. Put a catheter (thin tube) into the artery at the groin
4. With X-ray guidance, work the catheter up to arteries that bring blood to your kidneys
5. Use ultrasound (sound waves) or radiofrequency (radio waves) energy to destroy nerves on your kidneys’ arteries
6. Remove the catheter

What are the potential benefits and risks of this procedure?

Renal denervation treatment may work as well as taking one blood pressure medicine. It can lower your blood pressure by 5 to 10 millimeters of mercury (mmHg). This can help lessen your risk of heart or kidney issues.

After the procedure, your provider may change your blood pressure medicine doses. But you’ll still need to take blood pressure medicine and have healthy habits after renal denervation.

You may need to wait weeks or months to see results. For some people, this one-time procedure doesn’t work at all.

Renal denervation side effects (some are rare) may include:

• Pain for a day or two afterward (most common)
• Bleeding
• Infection
• Damage to an artery
• Blood clots
• Slow heart rate
• Narrowing in kidney arteries

Renal denervation recovery

Your healthcare team will monitor you to make sure your artery has stopped bleeding after the procedure. You may also need medicine for pain.

You can go home after renal denervation treatment. Most people don’t need to stay overnight at the hospital. You should receive instructions from your care team about caring for yourself at home. You should avoid exerting yourself for a few days after you get home.

You’ll need follow-up visits with your provider to check your blood pressure over the coming weeks and months. If your blood pressure comes down, your provider may decrease the amount of medicine you take. Only decrease your dose if your provider tells you to.

When should I call my healthcare provider?

Contact your provider if you have bleeding or signs of infection (like a fever) after you go home. Leg swelling, chest pain and shortness of breath could be signs of a blood clot. If you have these, get medical care right away.