It Takes Time After Bilateral Nephrectomy for Better Control of Resistant Hypertension in Renal Transplant Patients

Gawish, A.E.; Donia, F.; Fathi, Tarek; Al-Mousawi, M; Samhan, M.

doi:10.1016/j.transproceed.2010.04.014

Cited by 9 publications

(8 citation statements)

References 11 publications

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“…There have been several case reports in the literature suggesting that bilateral native nephrectomy can be beneficial in patients with severe resistant hypertension following renal transplant [1–7] .…”

Section: Introductionmentioning

confidence: 99%

Bilateral native nephrectomy for refractory hypertension in kidney transplant and kidney pancreas transplant patients

Lerman¹,

S²,

R³

2015

International Journal of Surgery Case Reports

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Section: Introductionmentioning

confidence: 99%

Bilateral native nephrectomy for refractory hypertension in kidney transplant and kidney pancreas transplant patients

Lerman¹,

S²,

R³

2015

International Journal of Surgery Case Reports

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“…Indications were drug-resistant proteinuria in six children, recurrent upper tract urosepsis in another six children, refractory hypertension in four children, malignancy/ malignant predisposition in four children and concomitant procedure during ureterocystoplasty in one child [8]. [6,[17][18][19][20][21][22][23][24]. Many causes of ESRD are associated with loss of proteins in urine.…”

Section: Indications For Native Nephrectomymentioning

confidence: 99%

Native Nephrectomy in Relation to Pediatric Renal Transplantation

ElSheemy¹

2016

JOJUN

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Nowadays, renal transplantation (RTx) is the best renal replacement therapy for children with end stage renal disease (ESRD) with the best survival. However, RTx in children is more challenging than adults with differences in many aspects including the etiology, the low circulatory volume and the more difficult maintenance of the extracellular fluid volume. In many instances, the native kidneys express a significant risk to the future renal graft. Consequently, native nephrectomy (NN) is indicated in these cases. This will be associated with more challenges related to the fluid management and nutrition in these children. This article will review the issue of NN in relation to pediatric RTx including its indications, its subsequent effect in children prepared for RTx, the proper timing for NN and precautions.The most common indications for NN are the presence of recurrent urinary tract infection (UTI) or proteinuria. Most of the diseases associated with these indications are more in children when compared with adults with ESRD due to the higher incidence of urologic anomalies and glomerulopathies. Although NN is associated with a reduction of the risk to the future renal graft as regard UTI and renal perfusion, it must be done with certain precautions to avoid any hazards to the child especially the risks resulting from loss of native urine production. Thus, timing of NN is very critical especially when bilateral NN is indicated. Medical treatment should be tried at first and if the condition is still refractory to treatment, a unilateral NN may be tried initially to keep at least one kidney as possible. Preservation of the native ureter is sometimes vital for the future possible ureteroureteral anasomosis or ureterocystoplasty particularly when facing post RTx ureteric complications.

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“…Deep brain stimulation has also been reported to lower blood pressure in one case, although the procedure was primarily undertaken to relieve neuropathic pain [99]. The old idea of surgically removing non-functioning kidneys has also received some support from a 12-patient series [100], although the procedure takes time to lower blood pressure in renal transplant patients [101].…”

Section: More Traditional Types Of Surgerymentioning

confidence: 99%

Management of Resistant Hypertension

Elliott

2011

Curr Cardiovasc Risk Rep

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Resistant" hypertension has been variously defined, but most authors accept a definition that includes a blood pressure ≥140/90 mm Hg after prescription of a diuretic and typically two other appropriately chosen antihypertensive drugs at near-maximal doses. Patients with resistant hypertension are of great public health importance because they have a high absolute cardiovascular and renal risk, greater health care expenditures, a higher prevalence of secondary hypertension and target-organ damage, and are, by definition, more "difficult to control" than hypertensive patients who are controlled with only one or two medications. Centers that specialize in these patients report that more than 90% can be diagnosed with a specific cause of their treatment resistance, and more than 50% can be controlled in a relatively short time after an appropriate intervention. This article reviews the differential diagnosis, evaluation, and outcomes of treatment paradigms for such patients, and emphasizes the role of hypertension specialists in their management.

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It Takes Time After Bilateral Nephrectomy for Better Control of Resistant Hypertension in Renal Transplant Patients

Cited by 9 publications

References 11 publications

Bilateral native nephrectomy for refractory hypertension in kidney transplant and kidney pancreas transplant patients

Bilateral native nephrectomy for refractory hypertension in kidney transplant and kidney pancreas transplant patients

Native Nephrectomy in Relation to Pediatric Renal Transplantation

Management of Resistant Hypertension

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