Key result
Renal denervation achieves 130/80 mmHg ambulatory BP and eliminates four antihypertensive drug classes at 6 months.
Why the study?
Resistant hypertension poses a significant therapeutic challenge that often leads to severe polypharmacy, while renal denervation has re-emerged as a valuable adjunctive intervention for blood pressure control.
Does catheter-based renal denervation improve blood pressure control and reduce medication burden in a patient with resistant hypertension and prior partial nephrectomy?
Case Report (n=1)
No
Does catheter-based renal denervation improve blood pressure control and reduce medication burden in a patient with resistant hypertension and prior partial nephrectomy?
Catheter-based renal denervation successfully controlled resistant hypertension and enabled significant de-escalation of polypharmacy in a patient with a prior partial nephrectomy.
May support BP control with medication reduction in resistant hypertension post-nephrectomy; extends case evidence but leaves open randomized confirmation.
Background: Resistant hypertension poses a significant therapeutic challenge, often leading to severe polypharmacy. Renal denervation (RDN) has re-emerged as a valuable adjunctive intervention for blood pressure control. Case Presentation: We report the case of a 64-year-old man (body mass index [BMI] 34 kg/m2) with long-standing resistant hypertension (RH), after previous percutaneous coronary intervention (PCI) to the left anterior descending artery, heart failure with preserved ejection fraction (HFpEF), and prior nephron-sparing surgery for clear cell renal carcinoma. Despite treatment with an extensive antihypertensive regimen encompassing nine pharmacological classes including diuretic therapy (angiotensin-converting enzyme inhibitor; calcium channel blocker, thiazide diuretic, β-blocker, α1-blocker, central α2-agonist, mineralocorticoid receptor antagonist, loop diuretic, long-acting nitrates), blood pressure remained severely uncontrolled on both home and office measurements. Persistent hypertension was accompanied by exertional dyspnoea and episodes of exertional chest discomfort. Following comprehensive evaluation and exclusion of secondary causes of hypertension, the patient underwent catheter-based renal denervation using the SymplicitySpyral™ (Medtronic) multi-electrode radiofrequency system. The procedure was associated with substantial and sustained improvement in blood pressure control, with mean 24 h ambulatory blood pressure measurements decreasing to 130/80 mmHg at six-month follow-up. Importantly, successful blood pressure reduction enabled major simplification of pharmacotherapy, including complete discontinuation of clonidine, loop diuretic therapy, and long-acting nitrates, together with marked dose reduction in doxazosin. Conclusions: This case illustrates the potential clinical utility of renal denervation in carefully selected patients with true resistant hypertension and pronounced sympathetic overactivity. Beyond achieving satisfactory blood pressure control, RDN may facilitate meaningful reduction in medication burden, potentially improving treatment adherence, quality of life, and long-term cardiovascular risk. Written informed consent was obtained from the patient for both the procedure and the publication of this case report.
No takes yet. Share an insight, caveat, or question.
Szwarkowska et al. (2026) conducted a case report in Resistant hypertension (n=1). Catheter-based renal denervation was evaluated on Mean 24 h ambulatory blood pressure. Catheter-based renal denervation reduced mean 24-hour ambulatory blood pressure to 130/80 mmHg at 6 months and enabled the discontinuation of four antihypertensive drug classes.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: