Renal Sympathetic Denervation for the Treatment of Difficult-to-Control or Resistant Hypertension

Figure 9

Results of microneurography before and after renal nerve ablation. Panel (a) shows the results of bilateral renal denervation, as assessed by the radiotracer dilution method, at baseline and 30 days after the procedure. After ablation, decreases in renal norepinephrine spillover were observed in both kidneys (48% in the left kidney and 75% in the right kidney), indicating substantial modulation of renal sympathetic efferent nerve activity after the procedure. Simultaneously, a marked reduction in whole-body sympathetic nerve activity was apparent, with a decrease in whole-body norepinephrine spillover of 42% (b). Panel (c) shows a reduction in muscle sympathetic-nerve activity (MSNA), as assessed in the peroneal nerve on microneurography, after bilateral renal nerve ablation, which highlights the possibility that inhibition of afferent renal-nerve activity may contribute to the reduction in central sympathetic drive.