Laparoscopic Renal Denervation and Perirenal Adipose Tissue Debulking for Refractory Hypertension in End-Stage Renal Disease.

Authors

Jiapeng Chu, Xiaolong Liu, Long Kuang, Hongxing Gu, Wenjun Xie, Zhihang Ni, Chunlai Shao

Published in

JACC. Case reports. Pages 110641. Oct 16, 2026. Epub Oct 16, 2026.

Abstract

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.
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.
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.
To our knowledge, this is the first report of RDN combined with PRAT debulking using the laparoscopic system in ESRD.
This combined intervention offers a promising new therapeutic option for refractory hypertension in patients with advanced kidney disease.

PMID:
42886134
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

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