Open AccessRenal Denervation in a Hypertensive Patient With End‐Stage Renal Disease and Small Arteries: A Direction for Future Research
Author(s) -
Ott Christian,
Schmid Axel,
Ditting Tilmann,
Sobotka Paul A.,
Veelken Roland,
Uder Michael,
Schmieder Roland E.
Publication year - 2012
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12017
Subject(s) - medicine , denervation , end stage renal disease , hemodialysis , cardiology , ambulatory blood pressure , blood pressure , catheter , renal artery , ambulatory , kidney disease , renal sympathetic denervation , kidney , urology , resistant hypertension , surgery
J Clin Hypertens (Greenwich) . 2012;14:799–801. ©2012 Wiley Periodicals, Inc. 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.