Renal Denervation:How Far Have We Got?

Primary hypertension,insulin resistance,congestive heart failure,and chronic functional renal diseases are all characterized by excessive central sympathetic activation.This effect is attributed to the kidney's somatic afferent nerves,which is one source of elevated central sympathetic drive.Chronic activation of the sympathetic nervous system has been related with components of the metabolic syndrome,such as blood pressure elevation,obesity,dyslipidemia,and impaired fasting glucose with hyperin-sulinemia.This article describes the selective removal of renal sympathetic nerves in patients with resistant hypertension,which both reduces the action of the central sympathetic drive and impacts diseases linked with excessive central sympathetic activation.