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Abundant evidence shows that chronic kidney disease (CKD) is a disease state characterized by increased sympathetic activation. Kidney injury (ischemia) plays a central role in this pathogenesis. Sympathetic excitation is associated with an increased risk of cardiovascular morbidity and mortality. Several pharmacologic strategies are developed to decrease(More)
Recently, catheter-based renal denervation (RDN) has become available. In order to understand better the possible role of RDN as a treatment modality, we first discuss the anatomy and function of the renal nerves in this brief review. Secondly, we address the question - what is the clinical evidence for the involvement of the kidneys and renal nerves in the(More)
BACKGROUND In patients with chronic kidney disease studies focusing on platelet function and properties often are non-conclusive whereas only few studies use functional platelet tests. In this study we evaluated a recently developed functional flow cytometry based assay for the analysis of platelet function in chronic kidney disease. METHODS Platelet(More)
Percutaneous ablation of the renal nerves [renal denervation (RDN)] has recently become available for treatment of (therapy-resistant) hypertension. In this review, the potential importance of RDN for patients with chronic kidney disease (CKD) is discussed. An overview of the role of the renal nerves is given, and the role of the kidneys as both generators(More)
Chronic pain is a common concern in patients with autosomal dominant polycystic kidney disease (ADPKD). We report what to our knowledge is the first catheter-based renal denervation procedure in a patient with ADPKD resulting in successful management of chronic pain. The patient was a 43-year-old woman whose chronic pain could not be controlled by pain(More)
Studies on the blood pressure lowering effect of renal denervation (RDN) in resistant hypertensive patients have produced conflicting results. Change in medication usage during the studies may be responsible for this inconsistency. To eliminate the effect of medication usage on blood pressure we focused on unmedicated hypertensive patients who underwent(More)
Randomized trials of catheter-based renal denervation (RDN) as therapy for resistant hypertension showed conflicting results in blood pressure (BP) lowering effect. Adherence to medication is modest in this patient group and may importantly drive these conflicting results. SYMPATHY is a prospective open label multicenter trial in Dutch patients with(More)
We report a 59-year-old, dark-complexioned black man with a giant basal cell carcinoma infiltrating virtually the entire scalp. Widespread metastatic bone marrow involvement produced a myelophthisic anemia. Basal cell carcinoma is rare in blacks, is rarely this large, and very rarely produces myelophthisic anemia from bone marrow metastases.
A 59-year-old woman presented with acute respiratory distress and a superior vena cava syndrome. Her complaints were initiated by esophageal food obstruction. A CT-scan revealed a massively dilated esophagus caused by achalasia. There was compression of the trachea and the large veins of the neck. Patient underwent esophageal resection and gastric tube(More)
OBJECTIVES To investigate the blood pressure dynamics after renal denervation through monthly home blood pressure measurements throughout the first 12 months. METHODS A cohort of 70 patients performed highly standardized monthly home blood pressure monitoring during the first year after denervation according to the European Society of Hypertension(More)