Safety of Renal Denervation as Treatment for Resistant Hypertension: A Systematic Review

Hypertension is very common throughout the world's population, which many people are unaware of, but it is still rising in population and causing a major public health problem. One of the methods used in treating resistant hypertension is renal denervation. However, studies on its safety and vascular complications effects are still unknown. The purpose of this study was to find out the safety of renal denervation in patients with resistant hypertension. This review was conducted on 10–17 December 2022. Two independent researchers systematically extracted data from several databases, such as PubMed Central (PMC), Science Direct, and PUBMED by using MeSH terminology of keywords renal denervation, hypertension, and safety. The extracted studies were then analyzed and selected according to our inclusion criteria such as studies in the last 5 years, cohort studies, and case-control studies. We excluded systematic reviews, meta-analyses, case series, case reports, studies on pregnant women, children, and animals. Research quality was assessed using Newcastle-Ottawa (NOS). From 4 cohort studies (166 subjects from various countries), 3 of them showed renal denervation has a favorable safety profile in gaining blood pressure control. The safety endpoint such as all-cause death and vascular complication were reached, but one study reported one patient with progression of renal artery stenosis and hypertensive urgency; All studies have proven good quality based on NOS. In conclusion, renal denervation showed efficacy by sustained blood pressure reducing effect in patients with resistant hypertension. However, further study is needed to confirm these findings.