title: Renal denervation in a patient with Alport syndrome and rejected renal allograft.
abstract: Renal denervation is a new intervention to treat resistant hypertension. By applying radiofrequency (RF) to renal arteries, sympathetic nerves in adventitia layer of vascular wall can be denervated. Sympathetic hyperactivity is an important contributory factor in hypertension of hemodialysis patients. Hyperactive sympathetic nervous system aggravates hypertension and it can cause complications like left ventricular hypertrophy, heart failure, arrhythmias and atherogenesis. Our report illustrates the use of renal denervation using conventional RF catheter for uncontrolled hypertension in a patient with Alport syndrome and rejected renal allograft. Progressive and sustained reduction of blood pressure was obtained post-procedure and at 24 months follow-up with antihypertensives decreased from 6 to 2 per day, thereby demonstrating the safety, feasibility, and efficacy of the procedure. There are some reports available on the usefulness of this technique in hemodialysis patients; however, there are no studies of renal denervation in patients with Alport syndrome and failed allograft situation.
authors.affiliation: Senior Resident, Department of Cardiology, Narayana Hrudayalaya, Bangalore, India. Electronic address: narayanarajucardio@gmail.com.
authors.forename: Narayana
authors.initials: N
authors.lastname: Raju
authors.affiliation: Senior Consultant Nephrologist, Narayana Hrudayalaya, Bangalore, India.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lloyd
authors.affiliation: Fellow in Electrophysiology, Narayana Hrudayalaya, Bangalore, India.
authors.forename: Sachin
authors.initials: S
authors.lastname: Yalagudri
authors.affiliation: Fellow in Electrophysiology, Narayana Hrudayalaya, Bangalore, India.
authors.forename: Bharati
authors.initials: B
authors.lastname: Das
authors.affiliation: Head of Electrophysiology and Arrhythmia Services, Narayana Hrudayalaya, Bangalore, India.
authors.forename: A G
authors.initials: AG
authors.lastname: Ravikishore
mesh_terms: D017115:Catheter Ablation / Q000379:methods*; D003714:Denervation / Q000379:methods*; D006084:Graft Rejection; D006801:Humans; D007668:Kidney / Q000294:innervation*; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D009394:Nephritis, Hereditary / Q000150:complications* / Q000601:surgery*; D006435:Renal Dialysis; D055815:Young Adult
keywords: Alport syndrome; Renal sympathetic denervation; Resistant hypertension