The Pathophysiological Basis of Renal Nerve Ablation for the Treatment of Hypertension
Ziakas A., Gossios T., Doumas M., Karali K., Megarisiotou A. and Stiliadis I.
Affiliation: 1stDepartment of Cardiology, Aristotle University, Thessaloniki, Greece.
Keywords: Renal nerve ablation, renal sympathetic denervation, anatomy, physiology, efferent renal sympathetic nerves, afferent
renal sympathetic nerves, renin, sodium reabsorption, renal blood flow, glomerular filtration rate.
Renal sympathetic innervation plays an important role in blood pressure regulation. Gradual activation of renal
sympathetic efferent nerves enhances renin release, promotes sodium and water re-absorption, and reduces renal blood
flow and glomerular filtration rate. On the other hand, activation of renal afferent sympathetic nerves induced by renal
injury results in central sympathetic activation. This reciprocal relationship between the kidneys and the brain is involved
in the pathogenesis of hypertension and other disease conditions characterized by sympathetic overactivity. Renal sympathetic
nerve ablation has been recently introduced for the treatment of resistant hypertension. This review aims to provide
the pathophysiological basis of renal nerve ablation for the attenuation of sympathetic overactivity.
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