IS BILATERAL NEPHRECTOMY IN END-STAGE RENAL DISEASE PATIENTS WITH REFRACTORY HYPERTENSION A LOST ART? – A CASE SERIES

8 Feb 2025 12 a.m. 12 a.m.

WCN25-AB-1349, Poster Board= SAT-045

Introduction:

In ESRD patients with HTN two modalities of management are used- pharmacological and optimizing volume with RRT. In a subset of patients who do not respond to either of these, bilateral nephrectomy can be used.

Methods:

Two cases, 11 year old male child and 25 year old female, cases of CKD-5D on MHD thrice weekly, presented with uncontrolled HTN with SBP> 220 mmHg and pulmonary edema. They had history of multiple admissions prior to this due to similar problems. Bilateral nephrectomy was done for both and asked to follow up in OPD with BP measurements. Later both patients underwent renal transplant and have normal renal function and controlled BP.

Results:

Both patients showed reasonable control of BP after nephrectomy. Below table and graph shows monthly follow up BP of the patients.

Duration	1st month	2nd month	3rd month	4th month	5th month	6th month
BP	190/110	150/102	146/100	148/106	148/96	150/102
Number of Antihypertensive drugs	7	5	5	3	4	2

Case 2: followed up for 2 months then underwent live related renal transplant

Duration	1st month	2nd month
BP	196/126	160/106
Number of Antihypertensive drugs	6	3

Conclusions:

Among the invasive interventions in treating resistant hypertension in patients with end-stage renal disease on dialysis despite dietary and lifestyle modifications, including increased dialysis time, decreased sodium dialysate, and the administration of multiple antihypertensive agents, bilateral nephrectomy is the most effective measure for treating hypertension in terms of lowering blood pressure, improving the clinical picture and quality of life, and reducing the number and dosage of antihypertensive medications in these patients.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.