JACC. Case reports · 2026
Laparoscopic Renal Denervation and Perirenal Adipose Tissue Debulking for Refractory Hypertension in End-Stage Renal Disease.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Chu Jiapeng, Liu Xiaolong, Kuang Long, Gu Hongxing, Xie Wenjun, Ni Zhihang, Shao Chunlai
Аннотация
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.
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.