PDF(Pubmed)
Abstract：
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.
摘要：
2012年，克罗地亚引入了肾脏去神经（RDN）作为治疗动脉高血压（AH）的方法。建立了一个多学科小组和医院网络，以诊断和治疗严重形式的AH患者，并准备了非常严格的诊断-治疗算法。在每月的会议上，讨论了RDN候选人的真正顽固性高血压患者。根据2021年ESH立场声明和2023年ESH指南，RDN被认为是一种替代和附加的，治疗各种形式AH的患者不是一种竞争性方法，必须遵循结构化程序进行，并且应考虑患者的偏好。鉴于全球科学界的变化，克罗地亚高血压联盟带来了关于使用射频导管进行RDN的共识文件，克罗地亚目前唯一可用的方法。在这份文件中,显示了排除和纳入标准，以及三组可考虑RDN的患者。准备了新的诊断治疗算法，并解释了后续程序。在克罗地亚,RDN由国家保险公司报销，因此，还显示了药物经济学分析。列出了单个中心需要批准RDN的标准，并计划在克罗地亚对RDN进行前瞻性研究，包括克罗地亚的RDN注册表，正在讨论。
