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<p>While renal denervation (RDN) represents a promising therapy for resistant hypertension, substantial heterogeneity in blood pressure-lowering efficacy and a significant treatment non-response rate (reaching up to one-third of cases) impede its broader clinical adoption. This variability likely arises from two primary sources: interindividual differences in sympathetic nervous system activation among hypertensive patients (the pathological substrate for ablation) and procedural limitations (“black-box procedure”) leading to incomplete sympathetic denervation. Our comprehensive review synthesizes recent advances in precision patient selection and procedural refinement for RDN. Furthermore, we propose a conceptual framework aimed at enhancing therapeutic consistency through the integrated optimization of patient stratification and ablation techniques. We believe this work provides insights to support the reliable clinical translation of RDN.</p><p></p>

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Overcoming variable response in renal denervation: Key strategies for reliable clinical implementation

  • 期刊论文

  • 发表日期：

    2025年11月27日

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  • Xianghao Zuo,
  • Yao Xiao,
  • Zhipeng Zhang,
  • Jiaxuan Xie,
  • Fang Wang,
  • Kai Wu,
  • Qin Xi,
  • Yong Peng,
  • Kai Liu,
  • Xiaoping Chen

摘要

While renal denervation (RDN) represents a promising therapy for resistant hypertension, substantial heterogeneity in blood pressure-lowering efficacy and a significant treatment non-response rate (reaching up to one-third of cases) impede its broader clinical adoption. This variability likely arises from two primary sources: interindividual differences in sympathetic nervous system activation among hypertensive patients (the pathological substrate for ablation) and procedural limitations (“black-box procedure”) leading to incomplete sympathetic denervation. Our comprehensive review synthesizes recent advances in precision patient selection and procedural refinement for RDN. Furthermore, we propose a conceptual framework aimed at enhancing therapeutic consistency through the integrated optimization of patient stratification and ablation techniques. We believe this work provides insights to support the reliable clinical translation of RDN.