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Renal Denervation Therapy in the Management of Hypertension on a 72-Year-Old Patient

Doctors at KIMSHEALTH Trivandrum, successfully performed Renal Denervation Therapy (RDN) on a 72-year-old man with resistant hypertension for many years. Renal denervation therapy offers a modern alternative for managing hypertension in people who usually are on 4-5 types of medicines every day, but are still hypertensive.

The patient, a native of Thiruvananthapuram, was on multiple antihypertensive drugs for many years. However, despite all efforts, his blood pressure remained as high as 180/90. Even though he underwent an angioplasty and stenting procedure for narrowing of the artery to the left kidney two years ago, his blood pressure did not stand abated.

Thus leading to the condition called 'Resistant Hypertension' which occurs due to an overactive Sympathetic Nervous System acting through the nerves that supply the kidneys. The Sympathetic Nervous System, a component of the body’s autonomic nervous system, typically prepares the body to respond to emergencies. However, in patients with resistant hypertension, this system becomes overactive, leading to increased production of certain hormones from the kidneys, ultimately resulting in high blood pressure.

Given his condition, we recommended RDN, a life-saving procedure in cases where blood pressure remains uncontrolled despite multiple medications, said Dr. Ramesh Natarajan, Senior Consultant & Coordinator, Department of Cardiology, who led the procedure.

A small puncture was made from which the catheter was carefully navigated inside the blood vessel to reach the kidney and the surrounding renal nerves. The renal nerves were then ablated (heated) using the catheter, resulting in a reduction in blood pressure levels and alleviating pressure on the kidney. The procedure, which lasted an hour, caused minimal discomfort to the patient, and was discharged the very next day. This is the second of its kind in the State and 23rd in the Country added Dr.Natarajan.

Dr. Subash S and Dr. Anil Radhakrishnan Pillai, Consultants, Department of Cardio-Thoracic Anesthesia, were also part of this procedure.