Can I stop my medicines after the procedure?

Usually not. Renal denervation does not replace medicines; your blood pressure medicines usually continue after the procedure. Your doctor adjusts the doses according to how your blood pressure changes. Do not stop any medicine or change its dose on your own.

Is renal denervation suitable for everyone?

No. It is an option that may be considered in selected patients and is not recommended as a first-line treatment. It needs to be confirmed with a 24-hour measurement that blood pressure stays high despite medicines, the medicines need to be taken regularly, other conditions that can raise blood pressure need to have been looked for, and the anatomy of the kidney arteries needs to be suitable. The method is not recommended for patients whose kidney function is moderately or severely reduced. The decision is made together with your doctor after discussing the possible benefits and risks.

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Renal denervation for resistant high blood pressure

The activity of the nerves around the kidney arteries is reduced using a thin catheter. In selected patients whose blood pressure stays high despite several medicines, it may help lower blood pressure; it does not replace medicines, cutting down on salt or lifestyle changes.

What is it?

There are nerves around the walls of the arteries that carry blood to the kidneys (the renal arteries). These nerves carry signals between the kidneys and the brain that contribute to raising blood pressure. In renal denervation (reducing the activity of the kidney nerves), radiofrequency (heat) or ultrasound energy is applied from inside the kidney arteries using a thin catheter advanced from the artery in the groin. The aim is to reduce the activity of these nerves and so help lower blood pressure in selected patients. The current European hypertension guideline describes this method as an option that may be considered in selected patients. These are patients whose blood pressure cannot be brought under control despite several medicines. According to the guideline, the procedure is carried out in centres that perform it regularly, with a decision made together with the patient after the possible benefits and risks have been discussed. The guideline does not recommend it as a first-line treatment. One reason is that it has not yet been shown in large enough studies to reduce events such as heart attack or stroke. Renal denervation does not replace medicines, cutting down on salt or lifestyle changes. Prof. Dr. Barış Kılıçaslan performs renal denervation in his clinical practice.

Who is it for?

Patients whose blood pressure stays high despite taking several blood pressure medicines regularly (usually three, including a water tablet), and in whom this has been confirmed with 24-hour blood pressure monitoring
Other conditions that can raise blood pressure (secondary causes) must have been looked for; if high blood pressure is due to such a condition, that is addressed first and renal denervation is not recommended in this situation
Kidney function needs to be adequate; this method is not recommended for patients whose kidney function is moderately or severely reduced
The decision is made together with your doctor, based on your blood pressure readings, test results and general health. This method does not replace medicines, cutting down on salt or lifestyle changes

Before the procedure

Before the procedure is considered, it is confirmed that your blood pressure really stays high despite medicines. A 24-hour blood pressure recording (ambulatory blood pressure monitoring) and regular home readings are used for this. Whether your medicines are being taken regularly and at the recommended doses is reviewed with you. Other conditions that can raise blood pressure (secondary causes) are looked for with blood and urine tests, and imaging if needed. Your kidney function is checked with a blood test. Whether the anatomy of the kidney arteries is suitable for the procedure is assessed, usually with an imaging method such as CT or MR angiography. Tell your doctor beforehand if you have ever had an allergy to contrast dye, or if you have kidney disease or diabetes. Your medications, especially blood thinners, are reviewed with your doctor; do not stop any medication on your own.

How is it done?

Access site: Usually the groin is cleaned and numbed with local anaesthetic, and sedation is also given so that you are comfortable during the procedure. A thin sheath is placed in the artery in the groin.
Imaging the kidney arteries: A thin catheter is advanced up to the kidney arteries. Dye is given and the arteries are imaged with X-ray to check that their anatomy is suitable for the procedure.
Energy delivery: Using a special catheter, radiofrequency or ultrasound energy is applied from inside both kidney arteries to the nerves around the artery wall. You may feel brief pain in the abdomen or lower back while the energy is delivered; pain relief and sedation are given for this.
Check and closure: The kidney arteries are imaged again to check them. The catheters are removed and the access site is closed with pressure or a closure device.

Recovery

After the procedure you stay under observation for a while, and the access site and your blood pressure are monitored. Because the groin was used, you may be asked to lie flat without bending your leg for a few hours to prevent bleeding. Any fall in blood pressure is not immediate and may be seen over weeks or months. The response varies from person to person; in some people blood pressure may not fall noticeably. After the procedure your blood pressure medicines usually continue. Your doctor adjusts the doses according to your home readings and check-up results; do not stop any medicine or change its dose on your own. Lifestyle measures such as cutting down on salt, regular activity and weight control continue.

Risks

Like every interventional procedure, renal denervation has risks. These include bleeding, bruising or swelling at the access site and an allergic reaction to the contrast dye. Rarely, damage to a kidney artery or a narrowing that develops later can occur. The dye used in the procedure can affect kidney function, especially in people who already have kidney disease. Your possible benefits and risks are explained in detail by your doctor, according to your personal situation, at the consultation before the procedure.

Frequently asked questions

Can I stop my medicines after the procedure? Usually not. Renal denervation does not replace medicines; your blood pressure medicines usually continue after the procedure. Your doctor adjusts the doses according to how your blood pressure changes. Do not stop any medicine or change its dose on your own.
Is renal denervation suitable for everyone? No. It is an option that may be considered in selected patients and is not recommended as a first-line treatment. It needs to be confirmed with a 24-hour measurement that blood pressure stays high despite medicines, the medicines need to be taken regularly, other conditions that can raise blood pressure need to have been looked for, and the anatomy of the kidney arteries needs to be suitable. The method is not recommended for patients whose kidney function is moderately or severely reduced. The decision is made together with your doctor after discussing the possible benefits and risks.
How soon might I see an effect? Any fall in blood pressure is not immediate and may be seen over weeks or months. The response varies from person to person; in some people blood pressure may not fall noticeably. For this reason your blood pressure is monitored after the procedure with home readings and check-ups.

Medical content reviewed and approved by Prof. Dr. Barış Kılıçaslan. Last updated: 4 October 2026. Editor: Baran Zeydan (info@clinixcrm.app).