[Bilateral nephrectomy by embolization of the renal arteries: a report on five cases (author's transl)].

Selective bilateral renal artery embolization was performed in 5 patients because of severe hypertension not responding to conventional medical treatment, in two patients on repeated dialysis; severe nephrotic syndromes with chronic renal insufficiency in the three other patients. A significant drop in blood pressure occurred in only two of the hypertensive patients, about 40 days after embolization. Bilateral surgical nephrectomy was required in the other patient because of persistence of residual vascularization and high RAP. Excellent results were obtained in the 3 patients with a nephrotic syndrome, with disappearance of proteinuria and anuria following the embolization. For this method to be effective, the arterial obliteration has to be complete and definitive. When symptoms persist or there is a relapse, especially in the cases with hypertension, a repeated arteriographic examination and complementary embolization has to be envisaged. Further experience with this method is necessary in order to compare the results with those obtained after bilateral surgical nephrectomy. Medical treatment with agents toxic to the tubules, in cases of the nephrotic syndrome, has apparently not produced the results expected. The relative simplicity of this embolization procedure has to be underlined, together with the fact that it is free from major complications when performed by surgeons trained in its use, on the condition that purification be carried out immediately following embolization.