Abstract
Hypertension is a major cause and the predominant accelerator of progressive loss of renal function in patients with chronic kidney disease (CKD). Despite advances in pharmacological intervention in recent years, a significant proportion of patients with CKD have uncontrolled, often treatment-resistant hypertension, necessitating alternative therapeutic approaches to control hypertension and slow the progression of renal function decline. Renal denervation modifies efferent and afferent renal sympathetic nerve activity and thus addresses an important modifier of both, blood pressure and renal function that has not been adequately addressed by pharmacologic therapies. This article reviews the current evidence on renal denervation in hypertensive patients with CKD. Safety and efficacy data from clinical trials and observational studies are reassuring that renal denervation is emerging as a promising additional treatment option for patients with uncontrolled hypertension and CKD. However, further randomized controlled data are needed to support these findings, particularly in patients with advanced CKD.