Abstract
Previous studies indicate that catheter-based renal denervation (RDN) reduces blood pressure and renal noradrenaline spillover in resistant hypertension. The effects of this procedure on afferent sensory and efferent sympathetic renal nerves, and the subsequent degree of reinnervation, have not been investigated. We examined the level of reinnervation 5.5 and 11 months after RDN using the Symplicity Flex catheter. Catheter-based RDN effectively ablated afferent and efferent nerves within the kidney. Eleven months after RDN, reinnervation was shown by the return of renal sympathetic nerve activity, normal responses to electrical stimulation and normal distribution of afferent and efferent nerves within the kidney. In addition we investigated the effects of catheter denervation on the nerves surrounding the renal arteries and changes within the dorsal root ganglia. In view of these data, the mechanisms underlying the prolonged hypotensive effect of catheter-based RDN in human resistant hypertension need to be reassessed. This work was supported by the National Health and Medical Research Council of Australia and the Victorian Government's Operational Infrastructure Support Program.
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