Medical nephrectomy: the last resort for intractable complications of the nephrotic syndrome

The large protein excretion of nephrotic syndrome leads to severe hypoalbuminemia and massive edema. The ensuing hyperlipidemia may not respond to any treatment unless protein losses are corrected. Urinary excretion of clotting factors due to nonselective proteinuria explains, at least in part, the development of a procoagulable state. We report herein four cases of intractable nephrotic syndrome that required medical nephrectomy by bilateral embolization of renal arteries. This procedure, although unusually performed, is an important therapeutic option in selected patients with nephrotic syndrome.