REducing Sympathetic Activity Through Ultrasound-based Renal deneRvation in Excessive Cardiovascular Risk populaTions.

This study is testing a procedure called ultrasound-guided renal denervation — where sound waves are used to disrupt overactive nerve signals from the kidneys — in people with serious cardiovascular and kidney conditions. The goal is to reduce the excessive nervous system activity that strains the heart and blood vessels. **You may be eligible if...** - You are between 18 and 75 years old - You have moderate to advanced chronic kidney disease (stage 3a or 3b), are on dialysis, or have mild to moderate heart failure with reduced pumping function - You are willing and able to provide informed consent **You may NOT be eligible if...** - You have anatomy that makes the procedure technically not possible - You have had a heart attack, stroke, or unstable chest pain in the past 3 months - You have been hospitalized for worsening heart failure in the past month - You have a serious inflammatory bowel condition (Crohn's or ulcerative colitis) - You are pregnant - You have a history of drug or alcohol dependency - You are currently in another clinical trial of an investigational device or drug Talk to your doctor to see if this trial is right for you.