Vascular Health and Risk Management (Dec 2023)

Renal Denervation in the Treatment of Resistant Hypertension and Difficult-to-Control Hypertension – Consensus Document of the Croatian Hypertension League – Croatian Society of Hypertension, Croatian Cardiac Society, Croatian Endovascular Initiative, Croatian Society for Diabetes and Metabolic Diseases, Croatian Renal Association, and Croatian Society of Family Physicians of the Croatian Medical Association

  • Jelaković B,
  • Perkov D,
  • Barišić K,
  • Bukal N,
  • Gellineo L,
  • Jelaković A,
  • Josipović J,
  • Prkačin I,
  • Željković Vrkić T,
  • Živko M

Journal volume & issue
Vol. Volume 19
pp. 805 – 826

Abstract

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Bojan Jelaković,1,2 Dražen Perkov,3 Klara Barišić,2 Nikolina Bukal,4 Lana Gellineo,2 Ana Jelaković,2 Josipa Josipović,5,6 Ingrid Prkačin,7 Tajana Željković Vrkić,8 Marijana Živko2 On the behalf of Task force for the Resistant Hypertension and Renal Denervation of the Croatian Hypertension League 1School of Medicine University of Zagreb, Zagreb, Croatia; 2Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia; 3Department of Diagnostic and Interventional Radiology, University Hospital Centre Zagreb, Zagreb, Croatia; 4Department of Internal Medicine, Nephrology and Pulmonology, General Hospital “Dr. J. Benčević”, Slavonski Brod, Croatia; 5Croatian Catholic University, Zagreb, Croatia; 6Department of Nephrology and Dialysis, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia; 7Department for Emergency Medicine, Clinical Hospital Merkur, Zagreb, Croatia; 8Institute for Cardiovascular Prevention and Rehabilitation, Zagreb, CroatiaCorrespondence: Ana Jelaković, University Hospital Centre Zagreb, Department for Nephrology, Arterial Hypertension, Dialysis and Transplantation, Kišpatićeva 12, Zagreb, 10000, Croatia, Email [email protected]: Renal denervation (RDN) as a method of treating arterial hypertension (AH) was introduced in Croatia in 2012. A multidisciplinary team and a network of hospitals that diagnose and treat patients with severe forms of AH were established, and a very strict diagnostic-treatment algorithm was prepared. At monthly meetings patients with truly resistant hypertension who were candidates for RDN were discussed. According to the 2021 ESH position statement and 2023 ESH guidelines, RDN is considered an alternative and additional, not a competitive method of treating patients with various forms of AH which must be performed by following a structured procedure and the patient’s preference should be considered. In view of the changes in the global scientific community, the Croatian Hypertension League brings this consensus document on RDN conducted with radiofrequency-based catheter, the only currently available method in Croatia. In this document, exclusion and inclusion criteria are shown, as well as three groups of patients in whom RDN could be considered. The new diagnostic-treatment algorithm is prepared and follow-up procedure is explained. In Croatia, RDN is reimbursed by the national insurance company, thus pharmacoeconomic analyses is also shown. Criteria required by an individual centre to be approved of RDN are listed, and plans for prospective research on RDN in Croatia, including the Croatian registry for RDN, are discussed.Keywords: hypertension, renal denervation, catheter- radiofrequency ablation, consensus, Croatia

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