Unilateral renal atrophy 4 years after renal sympathetic denervation: a case report

J Hypertens. 2023 Mar 1;41(3):516-519. doi: 10.1097/HJH.0000000000003350. Epub 2023 Jan 3.

Abstract

Renal sympathetic denervation (RDN) carries a low risk of renal artery stenosis, and most cases occur within the first year. However, limited data are available on long-term incidence. Here, we present a case of a 68-year-old woman who underwent radiofrequency RDN for resistant hypertension. Ambulatory blood pressure improved following RDN and uptitration of antihypertensive drugs. Between year 3 and 4 after RDN, eGFR reduced from 87 to 50 ml/min per 1.73 m 2 . Ultrasound imaging revealed left renal atrophy, while subsequent magnetic resonance angiography showed a haemodynamically significant stenosis of the left renal artery. The patient remained in good clinical condition with stable blood pressure, while eGFR mildly deteriorated during a 6-year follow-up period. This case of renal artery stenosis occurred in a patient with multiple risk factors. A causal relationship to the RDN procedure cannot be confirmed nor ruled out. Long-term surveillance for adverse events should be considered in all RDN patients.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure
  • Blood Pressure Monitoring, Ambulatory
  • Denervation
  • Female
  • Humans
  • Hypertension*
  • Kidney
  • Renal Artery Obstruction*
  • Sympathectomy / adverse effects
  • Sympathectomy / methods
  • Treatment Outcome

Substances

  • Antihypertensive Agents