Long-term control of hypertension and the predictive value of peripheral plasma renin activity after ablation of end stage kidneys with a new embolic agent.
Embolization of end-stage kidneys using our own embolizing agent Vilanol (partially hydrolyzed polyvinyl acetate) was performed in 10 patients with hypertension refractory to conservative therapy. Native kidneys were embolized in 7 patients with chronic renal failure, nonfunctioning renal transplants in 2 patients, and a shrunken kidney in 1 patient. Five of the 10 patients had high (9.96-18.2 ng/ml/h) peripheral renin (PR) levels. The embolization was technically successful in 4 of these 5 patients and was immediately followed by a marked decrease in PR, and simultaneous improvement in blood pressure (BP). The other 5 patients had very low PR levels (0.07-0.65 ng/ml/h), and a reduction in BP was observed in 4 after embolization. One patient died following embolization from cardiac arrest due to hyperkalemia. Six patients (3 in each group) have been on follow-up for 2-5 years with sustained decrease in BP. We conclude that the new agent is effective for renal ablation and control of refractory hypertension.
Peregrin
J H
JH
Department of Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
Zabka
J
J
Stríbrná
J
J
Borůvka
V
V
Martínek
V
V
D000328:Adult; D001794:Blood Pressure; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000503:physiopathology / Q000628:therapy*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls; D012077:Renal Artery; D012083:Renin / Q000097:blood*
D011145:Polyvinyls; C086287:Vilanol; D012083:Renin