Key result
Laparoscopic RDN with perirenal debulking substantially lowers blood pressure in ESRD.
Why the study?
Evidence regarding renal denervation in end-stage renal disease remains limited despite the role of renal sympathetic nerves and perirenal adipose tissue in driving hypertension.
Does laparoscopic renal denervation combined with perirenal adipose tissue debulking reduce blood pressure in a patient with end-stage renal disease and refractory hypertension?
Case Report (n=1)
Does laparoscopic renal denervation combined with perirenal adipose tissue debulking reduce blood pressure in a patient with end-stage renal disease and refractory hypertension?
A combined laparoscopic renal denervation and perirenal adipose tissue debulking strategy is feasible and may offer a promising new therapeutic option for refractory hypertension in advanced kidney disease.
Feasible in ESRD refractory hypertension; leaves open efficacy and safety in prospective trials.
BACKGROUND: Both renal sympathetic nerves and perirenal adipose tissue (PRAT) drive hypertension. However, evidence regarding renal denervation (RDN) in end-stage renal disease (ESRD) remains limited. FIRST-IN-HUMAN SUMMARY: A 74-year-old man with diabetic chronic kidney disease stage 5 presented with refractory hypertension despite treatment with 4 antihypertensive agents and intravenous nitroprusside. He underwent bilateral laparoscopic-assisted RDN combined with PRAT debulking without complications. At 5-month follow-up, office and ambulatory blood pressures were substantially reduced, while renal function and medications remained stable. DISCUSSION: Our case provides preliminary evidence supporting the feasibility of a combined laparoscopic RDN and PRAT debulking strategy in a patient with ESRD and refractory hypertension. NOVELTY: To our knowledge, this is the first report of RDN combined with PRAT debulking using the laparoscopic system in ESRD. TAKE-HOME MESSAGE: This combined intervention offers a promising new therapeutic option for refractory hypertension in patients with advanced kidney disease.
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Chu et al. (2026) conducted a case report in Refractory hypertension in end-stage renal disease (n=1). Bilateral laparoscopic-assisted renal denervation (RDN) combined with perirenal adipose tissue (PRAT) debulking was evaluated on Office and ambulatory blood pressures. Bilateral laparoscopic-assisted RDN combined with PRAT debulking substantially reduced office and ambulatory blood pressures at 5-month follow-up in a 74-year-old man with ESRD.
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