Renal nerve denervation via the renal pelvis

Abstract

Apparatus, systems, and methods provide access to the renal pelvis of a kidney to treat renal nerves embedded in tissue surrounding the renal pelvis. Access to the renal pelvis may be via the urinary tract or via minimally invasive incisions through the abdomen and kidney tissue. Treatment is effected by exchanging energy, typically delivering heat or extracting heat through a wall of the renal pelvis, or by delivering active substances.

What is claimed is: 
     
         1 . A system for inhibiting the function of renal nerves in a kidney of a patient suffering from hypertension, said system comprising:
 an effector comprising an array of electrodes configured to be advanced on a member into an interior of the kidney or an upper region of an adjacent ureter;   wherein the array of electrodes is configured to be expanded within the kidney or the upper region of the adjacent ureter to engage an interior wall of a renal pelvis and to deliver radiofrequency energy from the array of electrodes through the interior wall of the renal pelvis to ablate nerves within the wall of the renal pelvis wherein blood pressure of the patient is reduced; and   a continuous irrigation means through the member to cool the array of electrodes to reduce heat damage to tissue in contact with the electrodes.   
     
     
         2 . A system as in  claim 1 , wherein the member comprises a urinary catheter configured be advanced through the patient's urethra, the patient's bladder, and the patient's kidney or upper region of the adjacent ureter. 
     
     
         3 . A system as in  claim 1 , wherein the member comprises a percutaneous access tool configured to be advanced into the patient's retroperitoneal space and into a hilum of the patient's kidney. 
     
     
         4 . A system as in  claim 3 , wherein the percutaneous access tool is further configured to be advanced into the patient's renal pelvis 
     
     
         5 . A system as in  claim 1 , further comprising a controller. 
     
     
         6 . A system as in  claim 5 , wherein the controller is configured to deliver radiofrequency energy for a time in a range from 1 to 2 minutes. 
     
     
         7 . A system as in  claim 5 , wherein the controller is configured to deliver radiofrequency to raise a temperature of a tissue bed in the wall of the renal pelvis surrounding the nerves is raised to a temperature in a range from 45° C. to 60° C. 
     
     
         8 . A system as in  claim 1 , wherein the irrigating means is configured to maintain a temperature of papillae, parenchyma, and pyramids in the kidney below 45° C.