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Effects of renal denervation on the course of cardiorenal syndrome: insight from studies with fawn-hooded hypertensive rats.

Physiol Res

December 2024

Department of Pathophysiology, The Second Faculty of Medicine, Charles University, Prague, Czech Republic, Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

Combination of chronic kidney disease (CKD) and heart failure (HF) results in extremely high morbidity and mortality. The current guideline-directed medical therapy is rarely effective and new therapeutic approaches are urgently needed. The study was designed to examine if renal denervation (RDN) will exhibit long-standing beneficial effects on the HF- and CKD-related morbidity and mortality.

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Aorto caval fistulas.

Int Angiol

August 2024

Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia.

Article Synopsis
  • This study evaluates the outcomes of open surgical repair in 39 male patients with aorto-caval fistula caused by spontaneous rupture of an abdominal aortic aneurysm, documenting a high 30-day mortality rate of 35.9%.
  • The research involved a thorough review of clinical records at a Serbian medical center from January 2012 to February 2023, with a mean follow-up of 3.7 years for those who survived the surgery.
  • The findings suggest that given the serious nature of ACF and the risks associated with open repair, endovascular repair techniques are recommended as they may offer better outcomes.
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Article Synopsis
  • * A 71-year-old man with a history of heart issues experienced cardiac arrest due to an AAA rupture into the inferior vena cava, requiring emergency surgery.
  • * Successful management involved early recognition of an intraoperative right-to-left shunt via transesophageal echocardiography and the use of intra-aortic balloon occlusion to control severe bleeding.
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The aim was to evaluate the effects of renal denervation (RDN) on autoregulation of renal hemodynamics and the pressure-natriuresis relationship in Ren-2 transgenic rats (TGR) with aorto-caval fistula (ACF)-induced heart failure (HF). RDN was performed one week after creation of ACF or sham-operation. Animals were prepared for evaluation of autoregulatory capacity of renal blood flow (RBF) and glomerular filtration rate (GFR), and of the pressure-natriuresis characteristics after stepwise changes in renal arterial pressure (RAP) induced by aortic clamping.

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Renal nerves play a critical role in cardiorenal interactions. Renal denervation (RDN) improved survival in some experimental heart failure (HF) models. It is not known whether these favorable effects are indirect, explainable by a decrease in vascular afterload, or diminished neurohumoral response in the kidneys, or whether RDN procedure per se has direct myocardial effects in the failing heart.

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