Key result
Renal denervation resolves hypertensive emergencies and enables kidney transplant listing in refractory hypertension.
Why the study?
Hypertension is often poorly controlled in patients with end-stage renal disease on hemodialysis, and evidence for renal denervation in this population remains limited.
Does catheter-based bilateral renal denervation improve blood pressure control and enable kidney transplant listing in a hemodialysis-dependent patient with refractory hypertension?
Case Report (n=1)
No
Does catheter-based bilateral renal denervation improve blood pressure control and enable kidney transplant listing in a hemodialysis-dependent patient with refractory hypertension?
Catheter-based bilateral renal denervation may serve as an effective adjunctive therapy to control refractory hypertension and enable kidney transplant listing in hemodialysis-dependent patients.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for renal denervation in refractory hypertension on hemodialysis; leaves open confirmation in randomized trials.
Hypertension is often poorly controlled in patients with end-stage renal disease on hemodialysis, and evidence for renal denervation in this population remains limited. We describe a 38-year-old man with end-stage renal disease on hemodialysis because of thrombotic microangiopathy who developed refractory hypertension with recurrent hypertensive emergencies despite 6 antihypertensive agents and aggressive ultrafiltration, precluding kidney transplant listing. After a thorough secondary hypertension work-up, he underwent off-label catheter-based bilateral renal denervation, after which his blood pressure improved substantially, hypertensive emergencies ceased, and he was subsequently added to the transplant waitlist. Renal denervation may serve as adjunctive therapy to help dialysis patients with resistant hypertension reach transplant candidacy. Understand the limitations of pharmacologic and dialytic therapy for blood pressure control in dialysis-dependent patients. Appreciate how refractory hypertension may serve as a barrier to kidney transplant listing and how renal denervation may address it.
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Desai et al. (2026) conducted a case report in Refractory hypertension with end-stage renal disease on hemodialysis (n=1). Catheter-based bilateral renal denervation was evaluated on Blood pressure control, hypertensive emergencies, and kidney transplant waitlist eligibility. Catheter-based bilateral renal denervation substantially improved blood pressure and resolved hypertensive emergencies in a 38-year-old man on 6 drugs, enabling kidney transplant listing.
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