Key result
Bilateral catheter-based renal denervation reduced 24-hour ambulatory blood pressure by 38/30 mm Hg at 6 months in a woman with end-stage renal disease and small renal arteries.
Why the study?
Does bilateral catheter-based renal denervation reduce blood pressure in a patient with end-stage renal disease and small renal arteries?
Case Report (n=1)
Does bilateral catheter-based renal denervation reduce blood pressure in a patient with end-stage renal disease and small renal arteries?
Effect estimate: reduction of 38/30 mm Hg
Catheter-based renal denervation may be an effective strategy for controlling treatment-resistant hypertension in patients with ESRD, even when native renal arteries are small (<4 mm).
May support feasibility of renal denervation in ESRD with small arteries; leaves open efficacy and safety in larger cohorts.
Sympathetic overactivity plays a crucial pathogenetic role in the maintenance and aggravation of arterial hypertension in patients with end-stage renal disease (ESRD). Renal denervation has been shown to be effective and safe in reducing blood pressure (BP) in patients with treatment-resistant hypertension; however, there are only case reports in hypertensive patients with ESRD and data are lacking about possibility of renal denervation in small renal arteries. A woman with uncontrolled treatment-resistant hypertension on chronic hemodialysis underwent bilateral native kidney, catheter-based renal denervation. Both native renal arteries were <4 mm. After 6 months without any change of antihypertensive medication or hemodialysis parameters, the authors observed a remarkable BP reduction of 38/30 mm Hg (from baseline 172/100 mm Hg to 134/70 mm Hg) as evaluated by 24-hour ambulatory BP monitoring. The authors report that renal denervation seems to be effective in controlling hypertension in patients with ESRD, even in cases of small renal arteries.
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Ott et al. (2012) conducted a case report in treatment-resistant hypertension with end-stage renal disease (n=1). bilateral native kidney, catheter-based renal denervation was evaluated on blood pressure reduction evaluated by 24-hour ambulatory BP monitoring (reduction of 38/30 mm Hg). Bilateral catheter-based renal denervation reduced 24-hour ambulatory blood pressure by 38/30 mm Hg at 6 months in a woman with end-stage renal disease and small renal arteries.
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