title: Renal sympathetic nerve ablation for the treatment of difficult-to-control or refractory hypertension in a haemodialysis patient.
abstract: Haemodialysis patients show sympathetic hyperactivity. Hyperactivation of the sympathetic nervous system aggravates hypertension and it is related to left ventricular hypertrophy, heart failure, arrhythmias and atherogenesis. We report the first use of renal sympathetic nerve ablation for correction of uncontrolled hypertension in an end-stage renal disease patient on maintenance dialysis. We observed a progressive and sustained reduction of systemic blood pressure. Our case demonstrates the safety, the feasibility and the efficacy of this procedure. These findings suggest, however, that further clinical trials are needed into renal nerve radiofrequency ablation therapy for the treatment of hypertension and for the improvement of cardiovascular prognosis in this high-risk patient group.
authors.affiliation: Department of Internal Medicine, Tor Vergata University, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Di Daniele
authors.forename: Marianna
authors.initials: M
authors.lastname: De Francesco
authors.forename: Leano
authors.initials: L
authors.lastname: Violo
authors.forename: Alessio
authors.initials: A
authors.lastname: Spinelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
mesh_terms: D000328:Adult; D018660:Blood Pressure Monitoring, Ambulatory; D017115:Catheter Ablation; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D011379:Prognosis; D012077:Renal Artery / Q000294:innervation*; D006435:Renal Dialysis / Q000009:adverse effects*; D013562:Sympathectomy; D013564:Sympathetic Nervous System