Efficacy of renal denervation with and without antihypertensives in patients with resistant hypertension: A systematic review and meta-analysis
Department
Medicine
Document Type
Article
Publication Title
Nefrologia (Engl Ed)
Abstract
Background: Resistant hypertension presents a clinical challenge. The efficacy of renal denervation (RDN) as a potential treatment has conflicting data. Multiple randomized controlled trials have been conducted to assess the impact of RDN.
Methods: We performed systematic search of the PubMed and EMBASE from inception to April 2024 to identify studies comparing various interventions for resistant hypertension. We employed a frequentist network meta-analysis model, utilizing the net-meta module and applying a random effects model in CRAN-R software.
Results: Data of 2553 patients from 20 RCTs was analyzed. Standard mean differences (SMDs) for diastolic blood pressure (DBP) and systolic blood pressure (SBP) were assessed at different time points, including daytime, nighttime, over 24h, and during office visits. Our results demonstrate an improvement in various BP parameters when comparing RDN with sham: daytime DBP (3.46, 95%CI: [1.89-5.02], P< 0.0001), nighttime SBP (2.87, 95%CI: [1.43-4.31], P< 0.0001), 24-h SBP (2.82, 95%CI: [1.24-4.41], P=0.001), and in-office DBP (2.70, 95%CI: [1.04-4.36], P=0.002). However, no statistically significant difference was found in daytime SBP (3.60, 95% CI: [-0.67-7.87], P=0.10), nighttime DBP (1.65, 95% CI: [-0.57-3.86], P=0.15) and in-office SBP (3.89, 95% CI: [-10.07-17.86], P=0.60) and in 24-h DBP.
Conclusion: Our study supports the efficacy of RDN, when combined with antihypertensive treatment when compared to sham treatment, in the management of resistant hypertension.
First Page
501333
DOI
10.1016/j.nefroe.2025.501333
Volume
45
Issue
8
Publication Date
10-1-2025
Medical Subject Headings
Humans; Hypertension; Antihypertensive Agents; Kidney; Randomized Controlled Trials as Topic; Treatment Outcome; Sympathectomy; Combined Modality Therapy; Drug Resistance; Blood Pressure
PubMed ID
41173586
Recommended Citation
Adnan, M., Naveed, H., Hamza, M., Khalid, B., Safdar, W., Basit, J., Nassar, S., Upreti, P., Zafar, M., Javeed, Z., Prince, M., Sattar, Y., & Alraies, M. C. (2025). Efficacy of renal denervation with and without antihypertensives in patients with resistant hypertension: A systematic review and meta-analysis. Nefrologia (Engl Ed), 45 (8), 501333. https://doi.org/10.1016/j.nefroe.2025.501333