Sanders Margreet F, Blankestijn Peter J
Department of Nephrology and Hypertension, University Medical Centre Utrecht Utrecht, Netherlands.
Front Physiol. 2016 Jun 8;7:220. doi: 10.3389/fphys.2016.00220. eCollection 2016.
Renal denervation is being used as a blood pressure lowering therapy for patients with apparent treatment resistant hypertension. However, this population does not represent a distinct disease condition in which benefit is predictable. In fact, the wide range in effectiveness of renal denervation could be a consequence of this heterogeneous pathogenesis of hypertension. Since renal denervation aims at disrupting sympathetic nerves surrounding the renal arteries, it seems obvious to focus on patients with increased afferent and/or efferent renal sympathetic nerve activity. In this review will be argued, from both a pathophysiological and a clinical point of view, that chronic kidney disease is particularly suited to renal denervation.
肾去神经支配术正被用作治疗明显难治性高血压患者的一种降压疗法。然而，这一人群并不代表一种受益可预测的独特疾病状态。事实上，肾去神经支配术有效性的广泛差异可能是高血压这种异质性发病机制的结果。由于肾去神经支配术旨在破坏肾动脉周围的交感神经，因此关注肾传入和/或传出交感神经活动增加的患者似乎是显而易见的。在本综述中，将从病理生理学和临床角度论证，慢性肾脏病特别适合肾去神经支配术。
