BACKGROUND Antibodies against HLA antigens cause refractory allograft rejection with vasculopathy in some, but not all, patients. METHODS We studied 33 kidney-transplant recipients who had refractory vascular rejection. Thirteen had donor-specific anti-HLA antibodies, whereas 20 did not. Malignant hypertension was present in 16 of the patients without anti-HLA antibodies, 4 of whom had seizur...

Clinical and experimental data from the past two decades show that Decompressive Craniectomy (DC) is an effective treatment which reduces mortality within patients with refractory intracranial hypertension. Massive cerebral ischemic infarction and traumatic brain injury are the most frequent indication of DC. Since the conservative medical treatment of intracranial hypertension is ineffective i...

BACKGROUND We aimed to estimate the prevalence of refractory hypertension (RfH) and to determine the clinical differences between these patients and resistant hypertensives (RH). Secondly, we assessed the prevalence of white-coat RfH and clinical differences between true- and white-coat RfH patients. METHODS AND RESULTS The present analysis was conducted on the Spanish Ambulatory Blood Pressu...

BACKGROUND Hypertension continues to be a major burden of public health concern despite the recent advances and proven benefit of pharmacological therapy. A certain subset of patients has hypertension resistant to maximal medical therapy and appropriate lifestyle measures. A novel catheter-based technique for renal denervation (RDN) as a new therapeutic avenue has great promise for the treatmen...

main goal in the management of patients with severe traumatic brain injury (tbi) is control of intracranial pressure (icp). decompressive craniectomy is an accepted technique for control of refractory intracranial hypertension in patients with severe tbi. because of high complication rate after decompressive craniectomy, new techniques such as basal cisternostomy have developed. we herein repor...

We report the case of a 38-week gestational age neonate, with isolated congenital diaphragmatic hernia presenting with refractory persistent pulmonary hypertension, systemic hypotension, and hypoxemia, resistant to usual therapeutics. Arginine vasopressin is responsible for systemic vasoconstriction and decreases pulmonary hypertension. We theorized that terlipressin, its long-acting analogue, ...

A 20-year-old woman presented with malignant hypertension, pulmonary edema, anemia, and azotemia. Blood pressure was adequately controlled only after progressively more intensive drug regimens, finally including minoxidil, nadolol, and furosemide. On these drugs, the patient developed progressive left and right heart failure, anasarca, and malnutrition. The control of hypertension, heart failur...

Resistant hypertension, defined as blood pressure (BP) remaining above goal despite the use of 3 or more antihypertensive medications at maximally tolerated doses (one ideally being a diuretic) or BP that requires 4 or more agents to achieve control, occurs in a substantial proportion (>10%) of treated hypertensive patients. Refractory hypertension is a recently described subset of resistant hy...