Progressive renal failure in a patient after one and two-thirds nephrectomy.

We report on a patient who lost one and two-thirds of his kidneys following surgery because of bilateral renal cell carcinoma. The serum creatinine following surgical intervention increased to about 7 mg% and fell to serum values of about 3 mg% in the year after one and two-thirds nephrectomy. The patient's renal function remained stable for 18 months, then it started to deteriorate and the patient developed progressive renal failure with proteinuria. The course of the disease suggests that an intrinsic renal mechanism was operative, which relates to glomerular hyperfiltration following surgical loss of renal tissue.