Experience with one-stage bilateral nephrectomy

Eight patients with uremia were treated by one-stage transperitoneal bilateral nephrectomy prior to transplantation. Four of the patients had refractory hypertension with high peripheral renin activity which was unresponsive to drug treatment and vigorous hemodialysis. All obtained a normal blood pressure after operation. Two patients were nephrectomised to combat chronic infection, whilst one of the two remaining patients suffered from huge polycystic kidneys and the other had suspected Goodpasture syndrome. There were no deaths and the only complications observed were one instance of hyperkalemia necessitating acute hemodialysis and one instance of prolonged ileus. Our indications for doing the operation prior to transplantation have been very restricted, but when the operation becomes necessary, it is a safe procedure.