Why the study?
Does bilateral nephrectomy and right adrenalectomy improve resistant hypertension in a hemodialysis patient with secondary aldosteronism?
Does bilateral nephrectomy and right adrenalectomy improve resistant hypertension in a hemodialysis patient with secondary aldosteronism?
Bilateral nephrectomy is a potentially effective treatment option for resistant hypertension with an elevated renin-angiotensin-aldosterone system in hemodialysis patients.
May support bilateral nephrectomy in rare refractory hypertension on hemodialysis; hypothesis-generating and requires prospective trials.
A 42-year-old Japanese woman with end-stage renal failure due to hypertension presented with a systolic blood pressure of 160-200 mmHg despite treatment with 4 different antihypertensive agents. The plasma aldosterone concentration (PAC) and plasma renin activity (PRA) were elevated. Adrenal vein sampling suggested bilateral excessive aldosterone secretion, whereas adrenocortical scintigraphy showed right-dominant accumulation. Open bilateral nephrectomy and right adrenalectomy improved the systolic blood pressure, PAC, and PRA. A pathological examination revealed zona glomerulosa hyperplasia but not microaldosteronoma. This report shows that bilateral nephrectomy, not unilateral adrenalectomy, is a potentially effective treatment option for resistant hypertension with an elevated renin-angiotensin-aldosterone system in hemodialysis patients.
No takes yet. Share an insight, caveat, or question.
Nishihama et al. (2023) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: