Methods for renal neuromodulation

Abstract

Methods and apparatus are provided for treating hypertension, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney.

1 . A method for treating hypertension, the method comprising:
 modulating a function of a neural fiber that contributes to renal function of a kidney of a patient,   wherein modulating the function of the neural fiber further comprises modulating the function without completely physically severing the neural fiber.   
     
     
         2 . The method of  claim 1 , wherein modulating the function of the neural fiber further comprises modulating the function of the neural fiber via an electric field. 
     
     
         3 . The method of  claim 2 , wherein modulating the function of the neural fiber via an electric field further comprises exposing the neural fiber to a pulsed electric field. 
     
     
         4 . The method of  claim 2 , wherein modulating the function of the neural fiber via an electric field further comprises exposing the neural fiber to a stimulation electric field. 
     
     
         5 . The method of  claim 1 , wherein modulating the function of the neural fiber further comprises delivering a neuromodulatory agent to the neural fiber. 
     
     
         6 . The method of  claim 1 , wherein modulating the function of the neural fiber further comprises at least partially denervating the kidney. 
     
     
         7 . The method of  claim 1 , wherein modulating the function of the neural fiber further comprises inducing an effect in the neural fiber chosen from the group consisting of irreversible electroporation, electrofusion, necrosis, apoptosis, gene expression alteration, cytokine up-regulation alteration, and combinations thereof. 
     
     
         8 . The method of  claim 1 , wherein modulating the function of the neural fiber further comprises thermally modulating the function of the neural fiber. 
     
     
         9 . The method of  claim 1 , wherein modulating the function of the neural fiber further comprises modulating the function of the neural fiber with high frequency ultrasound. 
     
     
         10 . A method for treating hypertension, the method comprising:
 modulating a function of a neural fiber that contributes to renal function of a kidney of a patient,   wherein modulating the function of the neural fiber further comprises modulating the function via a percutaneous approach.   
     
     
         11 . The method of  claim 10 , wherein modulating the function via a percutaneous approach further comprises modulating the function via a laparoscopic approach. 
     
     
         12 . The method of  claim 10 , wherein modulating the function via a percutaneous approach further comprises modulating the function via an endoluminal approach. 
     
     
         13 . The method of  claim 10 , wherein modulating the function of the neural fiber further comprises modulating the function of the neural fiber via an electric field. 
     
     
         14 . The method of  claim 13 , wherein modulating the function of the neural fiber via an electric field further comprises exposing the neural fiber to a pulsed electric field. 
     
     
         15 . The method of  claim 13 , wherein modulating the function of the neural fiber via an electric field further comprises exposing the neural fiber to a stimulation electric field. 
     
     
         16 . The method of  claim 10 , wherein modulating the function of the neural fiber further comprises delivering a neuromodulatory agent to the neural fiber. 
     
     
         17 . The method of  claim 10 , wherein modulating the function of the neural fiber further comprises at least partially denervating the kidney. 
     
     
         18 . The method of  claim 10 , wherein modulating the function of the neural fiber further comprises inducing an effect in the neural fiber chosen from the group consisting of irreversible electroporation, electrofusion, necrosis, apoptosis, gene expression alteration, cytokine up-regulation alteration, and combinations thereof. 
     
     
         19 . The method of  claim 10 , wherein modulating the function of the neural fiber further comprises thermally modulating the function of the neural fiber. 
     
     
         20 . The method of  claim 10 , wherein modulating the function of the neural fiber further comprises modulating the function of the neural fiber with high frequency ultrasound.