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 method for inhibiting the function of renal nerves in a kidney of a patient suffering from hypertension, said method comprising:
 advancing an effector comprising an array of electrodes through the urinary tract into an interior of the kidney or an upper region of an adjacent ureter;   drawing a vacuum through ports on the effector to collapse the wall of the renal pelvis onto the electrodes   delivering radiofrequency energy to the array of electrodes through the interior wall of the renal pelvis to afferent sensory nerves within the wall of the renal pelvis while the wall is collapsed on the electrodes wherein blood pressure of the patient is reduced.   
     
     
         2 . The method as in  claim 1 , wherein the wall of the renal pelvis is partially collapsed onto the electrodes. 
     
     
         3 . The method as in  claim 1 , wherein the effector is advanced to a location where a proximal-most electrode is advanced past a ureteral os. 
     
     
         4 . A method as in  claim 1 , wherein the vacuum is drawn in a lower portion of the renal pelvis. 
     
     
         5 . A method as in  claim 1 , wherein the vacuum is drawn from a vacuum source and the radiofrequency energy is delivered from a radio frequency power source. 
     
     
         6 . A method as in  claim 5 , wherein the vacuum source and the radio frequency power source are both disposed in an external power supply/controller. 
     
     
         7 . A method as in  claim 1 , wherein a temperature of a tissue bed surrounding the afferent sensory nerves in the wall of the renal pelvis is raised to a temperature in a range from 45° C. to 60° C. 
     
     
         8 . A method as in  claim 7 , further comprising irrigating the expanded electrodes to maintain a temperature of the papillae, the parenchyma, and the pyramids in the kidney below 45° C. 
     
     
         9 . A method as in  claim 1 , further comprising expanding the array of electrodes within the kidney or upper region of an adjacent ureter to engage an interior wall of the renal pelvis. 
     
     
         10 . A method as in  claim 1 , wherein the effector is advanced through the urethra, bladder, and ureter to reach the renal pelvis. 
     
     
         11 . A method as in  claim 1 , wherein the radiofrequency energy is delivered for a time in a range from 1 to 2 minutes.