Wegman, M. and Thomas, S. and Deuber, HJ. (2011): Renal denervation in patients with essential hypertonia. Decision Support Document 45.
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Background and objectives: One of the pathologic mechanisms in essential hypertonia is renal sympathic activation by nerves of the renal artery. The new method of catheter based renal denervation is used to prevent this pathway. This review summarizes the evidence of this new method by means of efficacy and safety. Based on the evidence a recommendation is made regarding the inclusion of renal denervation into the Austrian hospital services catalogue.
Method: A literature search identified 55 records. According to predefined criteria two studies were included for the analysis and synthesis of the evidence, which quality was assessed by using the GRADE scheme.
Results: One RCT and one before-after-study provide the basis for assessing the benefit-harm balance of renal denervation. The before-after study is limited due to its’ study design and, therefore, has no essential contribution to the overall evidence. In contrast, the RCT offers a more valid study design and is therefore the main contributor to the evidence but, however, has some study design limitations, too. Regarding the outcomes, the RCT shows a lowering effect on blood pressure. Nevertheless it does not provide information on mortality, long-term efficacy and quality of life.
Conclusion and Recommendation: Given the current paucity of evidence renal denervation in essential hypertonia can currently not be recommended for the Austrian hospital services catalog.
|Item Type:||Decision Support Document|
|Additional Information:||This Document was written in cooperation with the MDS, that means by MDS-editors under LBI-HTA's project leadership.|
|Keywords:||Hypertension, hypertony, sympathectomy, kidney innervation, endovascular therapy, catheter ablation|
|Subjects:||WG Cardiovascular system|
WO Surgery > WO 505 Minimally invasive surgical procedures
WL Nervous system > WL 600-610 Autonomic nervous system
|Series Name:||Decision Support Document 45|
|Deposited on:||15 Jul 2011 01:23|
|Last Modified:||15 Jul 2011 01:23|
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