Resistant hypertension treated with laparoscopic-assisted renal denervation in a patient with end-stage renal disease: a case report

European Heart Journal - Case Reports

12 August 2025
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ESC Journals CARDIOVASCULAR DISEASE IN SPECIFIC POPULATIONS HYPERTENSION Interventional Cardiology

Abstract

AbstractBackground

In patients with end-stage renal disease (ESRD) on dialysis, hypertension is commonly detected and inadequately controlled despite the use of multiple anti-hypertensive medications. Sympathetic hyperactivation is a key feature in chronic kidney disease and can be targeted by renal denervation (RDN).

Case summary

A 47-year-old male patient with pharmacologically resistant hypertension and ESRD on peritoneal dialysis underwent radiofrequency renal nerve ablation using a laparoscopic-assisted system. During the 6-month follow-up after the operation, we observed a remarkable and sustained reduction in blood pressure, with a significant decrease in oral anti-hypertensive medications.

Discussion

This case demonstrates the safety and effectiveness of laparoscopic-assisted RDN for lowering blood pressure. This technology, as an alternative to catheter-based RDN, bears the potential for wider application in high-risk patients with severe renal failure.