Laparoscopic bilateral nephrectomy for renin-mediated hypertension.
Hypertension arising from retained native kidneys complicates the management of recipients of renal transplants. Reluctance to administer angiotensin-converting enzyme inhibitor (ACEI) drugs to patients taking cyclosporine has reopened the question of performing native nephrectomies for poorly controlled, renin-dependent hypertension. We report the first published cases of simultaneous bilateral laparoscopic nephrectomies in 2 patients: 1 in preparation for living-related donor transplantation and the other ten months following cadaver transplantation in a patient whose end-stage renal disease was from malignant nephrosclerosis. Both had very severe hypertension resistant to multiple drugs and both became normotensive with little or no antihypertensive medication following nephrectomies. A bilateral nephrectomy is currently feasible using a laparoscopic approach.
Bales
G T
GT
Department of Surgery, University of Chicago Hospital, Illinois.
Fellner
S K
SK
Chodak
G W
GW
Rukstalis
D B
DB
D000328:Adult; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D011300:Preoperative Care; D012083:Renin / Q000502:physiology
D012083:Renin