Table 1. Clinical context and indications for renal denervation.

Recommendations	Class*	Level#
Clinical context
Renal denervation should be performed in the context of registry and clinical studies	I	C
Renal denervation should not be performed without detailed evaluation of various causes of secondary hypertension and renal artery anatomy	III	C
Blood pressure indications
Renal denervation can be performed in patients with office SBP ≥ 150 mmHg and DBP ≥ 90 mmHg and daytime ambulatory SBP ≥ 135 mmHg or DBP ≥ 85 mmHg, irrespective of use of anti-hypertensive agents, and with eligible renal artery anatomy and eGFR ≥ 45 mL/min/1.73 m2	IIa	B
Renal denervation can be performed in patients with 24-hour ambulatory SBP ≥ 140 mmHg and DBP ≥ 80 mmHg, irrespective of use of antihypertensive agents, and with eligible renal artery anatomy and eGFR ≥ 45 mL/min/1.73 m2	IIa	B
Patient indications
Patients been treated with maximally tolerated doses of BP-lowering drugs of ≥ 3 classes for ≥ 1 month and fulfilling either of the above BP criteria, with eligible renal artery anatomy and eGFR ≥ 45 mL/min/1.73 m2	IIa	B
Patients with hypertension-mediated organ damage or established cerebro- or cardio-vascular disease been treated with maximally tolerated doses of BP-lowering drugs of ≥ 3 classes (or fewer if intolerable) for ≥ 1 month and fulfilling either of the above BP criteria, with eligible renal artery anatomy and eGFR ≥ 45 mL/min/1.73 m2	IIa	C
Patients intolerant or non-adherent to antihypertensive agentsand fulfilling either of the above BP criteria, with eligible renal artery anatomy and eGFR ≥ 45 mL/min/1.73 m2	IIa	B
Patients with secondary causes of hypertension (excluding obstructive sleep apnea) been de-finitively treated for ≥ 3 months and fulfilling either of the above BP criteria, with eligible renal artery anatomy and eGFR ≥ 45 mL/min/1.73 m2	IIb	C
Patients with obstructive sleep apnea been definitively treated for ≥ 3 months and fulfilling either of the above BP criteria, with eligible renal artery anatomy and eGFR ≥ 45 mL/min/1.73 m2	IIa	B

BP, blood pressure; DBP, diastolic blood pressure; eGFR, estimated glomerular filtration rate; SBP, systolic blood pressure.

* Class of recommendation, ^# Level of evidence.