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Experience with one-stage bilateral nephrectomy

H K Petersen, B B Moller

    Scandinavian Journal of Urology and Nephrology
    |January 1, 1976
    PubMed
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    Bilateral nephrectomy before kidney transplantation is a safe procedure for uremic patients, effectively managing refractory hypertension and other complications. This surgical approach led to normal blood pressure in all treated patients.

    Area of Science:

    • Nephrology
    • Transplant Surgery
    • Urology

    Background:

    • Uremia presents complex challenges, including refractory hypertension and chronic infections.
    • Pre-transplant nephrectomy is considered for specific, severe uremic complications.
    • High peripheral renin activity is a significant factor in refractory hypertension.

    Purpose of the Study:

    • To evaluate the safety and efficacy of one-stage transperitoneal bilateral nephrectomy prior to kidney transplantation.
    • To assess the impact of nephrectomy on refractory hypertension and other indications in uremic patients.

    Main Methods:

    • One-stage transperitoneal bilateral nephrectomy was performed on eight uremic patients before kidney transplantation.
    • Patients included those with refractory hypertension, chronic infection, polycystic kidneys, and suspected Goodpasture syndrome.

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    Main Results:

    • All eight patients survived the procedure with no deaths.
    • Four patients with refractory hypertension achieved normal blood pressure post-nephrectomy.
    • Complications were minimal, including one case of hyperkalemia and one of prolonged ileus.

    Conclusions:

    • One-stage transperitoneal bilateral nephrectomy is a safe and effective procedure when indicated before kidney transplantation.
    • The surgery successfully resolved refractory hypertension and addressed other serious uremic complications.
    • Restricted indications for this pre-transplant surgery are appropriate, but it remains a viable option when necessary.