Key result
Bilateral nephrectomy successfully treated life-threatening refractory hypertension in a patient with stage 3b chronic kidney disease who was previously unresponsive to renal denervation.
Why the study?
Renal denervation has yet to show adequate blood pressure reductions for the average patient with refractory hypertension, and bilateral nephrectomy has thus far been reserved for patients with preexisting end-stage kidney disease.
Does bilateral nephrectomy improve life-threatening refractory hypertension in a patient with stage 3b chronic kidney disease?
Case Report (n=1)
Does bilateral nephrectomy improve life-threatening refractory hypertension in a patient with stage 3b chronic kidney disease?
Bilateral nephrectomy may be a viable treatment option for life-threatening refractory hypertension in select patients prior to developing end-stage kidney disease.
May support bilateral nephrectomy for rHTN after failed RDN in non-ESKD CKD; hypothesis-generating, should not yet change practice.
We present a case of life-threatening refractory hypertension (rHTN) in a patient with stage 3b chronic kidney disease that was unresponsive to open surgical renal denervation (RDN) but responded to bilateral nephrectomy (BLN). Both RDN and BLN reduce the increased sympathetic activation in rHTN. However, RDN has yet to show reductions in blood pressure adequate for the average patient with rHTN, and BLN has thus far been reserved for patients with preexisting end-stage kidney disease (ESKD). Our case suggests that there are patients with rHTN that warrant consideration of BLN prior to developing ESKD.
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Zemke et al. (2021) conducted a case report in Refractory hypertension and stage 3b chronic kidney disease (n=1). Bilateral nephrectomy was evaluated on Blood pressure response. Bilateral nephrectomy successfully treated life-threatening refractory hypertension in a patient with stage 3b chronic kidney disease who was previously unresponsive to renal denervation.
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