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Circadian rhythm of blood pressure restoration and nephrotic proteinuria alleviation in a patient with chronic kidney disease after renal sympathetic denervation

Ingrid Prkačin orcid id orcid.org/0000-0002-5830-7131 ; Department of Internal Medicine, Merkur University Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia
Valentina Ćorić-Martinović ; Department of Internal Medicine, Vinkovci General Hospital, Vinkovci, Croatia
Tomislav Bulum ; Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, Zagreb, Croatia
Gordana Cavrić ; Department of Internal Medicine, Merkur University Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia
Vesna Đermanović-Dobrota ; Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, Zagreb, Croatia
Vinko Vidjak ; Department of Radiology, Merkur University Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia


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Abstract

Renal sympathetic denervation (RSD) could be an effective antihypertensive treatment of resistant hypertension that triggers additional positive effects on glucose metabolism and insulin sensitivity in type 2 diabetes mellitus. We report the effects of RSD in a patient with chronic kidney disease, type 2 diabetes mellitus and resistant hypertension, manifesting as blood pressure reduction with dipping pattern restoration, followed by nephrotic proteinuria alleviation. The non-dipping blood pressure pattern and proteinuria increase the risk of cardiovascular complications and accelerate kidney disease progression. Thus, further research documenting the frequency and investigating the mechanisms of these effects reported after RSD in chronic kidney disease patients with type 2 diabetes mellitus and resistant hypertension is necessary for the benefit of this
high-risk patient population.

Keywords

Circadian rhythm; Diabetic nephropathies; Proteinuria; Hypertension – drug therapy; Kidney – innervation; Sympathectomy – methods

Hrčak ID:

156239

URI

https://hrcak.srce.hr/156239

Publication date:

1.12.2015.

Article data in other languages: croatian

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