Abstract
In patients with nephrotic syndrome and life-threatening protein loss resistant to therapy, a percutaneous transfemoral kidney ablation can be performed as a last measure. In three patients, one with membrano-proliferative glomerulonephritis and two with amyloidosis, a bilateral renal artery embolization was able to terminate proteinuria successfully. Nevertheless, one patient died 14 days later because of septicaemia and sepsis, due to prolonged loss of gamma globulin. The other two patients survived, although for permanent haemodialysis. In life-threatening desperate situations, catheter-aided renal embolization is a fast and effective alternative to nephrectomy.
Similar content being viewed by others
References
Greenstein AJ, Janowitz HD, Sachar DB (1976) The extraintestinal complication of Crohn's disease and ulcerative colitis: a study of 700 patients. Medicine 55: 401–407
Steinhoff J, Schulz E, Herbst EW, Fricke L, Sack K (1988) Therapie der Amyloidnephrose bei Morbus Crohn: Plasmapherese plus Azathioprin? Wien Med Wochenschr 138: 49–54
Westermark P, Sletten K, Erikson M (1979) Morphologic and chemical variation of kidney lesions in amyloidosis secondary to rheumatoid arthritis. Lab Invest 41: 427–431
Banowsky LH (1976) The role of adjuvant operations in renal transplantation. Urol Clin North Am 3: 527–551
Mitchell TS, Halasz NA, Gittes GF (1973) Renal transplantation: selective preliminary bilateral nephrectomy. J Urol 109: 796–801
Sheinfeld J, Linke CL, Talley TE, Linke CA (1985) Selective pre-transplant nephrectomy: indications and perioperative management. J Urol 133: 379–382
Keller FS, Coyle M, Rösch J, Dotter CT (1986) Percutaneous renal ablation in patients with end-stage renal disease: alternative to surgical nephrectomy. Radiology 159: 447–451
McCarron DA, Rubin RJ, Barnes BA, Harrington JT, Millan VG (1976) Therapeutic bilateral renal infarction in end-stage renal disease. N Engl J Med 294: 652
Lowenstein J, Gallo G (1970) Remission of the nephrotic syndrome in renal amyloidosis. N Engl J Med 282: 128–130
Lytton B (1986) Surgery of the kidney. In: Walsh PC, Gittes RF, Perlmutter AD, Stamey TA (eds) Cambell's urology. Saunders, Philadelphia, 2406–2453
Dotter CT, Goldman ML, Rosch J (1975) Instant selective arterial occlusion with isobutyl-2-cyanoacrylate. Radiology 114: 227–230
Henrich WL, Goldman M, Dotter CT, Rosch J, Bennett WM (1996) Therapeutic renal arterial occlusion for elimination of proteinuria. Arch Intern Med 136: 840–842
Wu MJ, Moorthy AV, Beirne GJ, Crummy AB (1980) Renal ablation with Gianturco wool coils. JAMA 243: 2425–2426
Nanni GS, Hawkins IF Jr, Orak JK (1983) Control of hypertension by ethanol renal ablation. Radiology 148: 51–54
Lieberman SF, Keller FS, Pearse HD, Fuchs EF, Rosch J, Barry JM (1983) Percutaneous vaso-occlusion for nonmalignant renal lesions. J Urol 129: 805–809
Novak D (1990) Complications of arterial embolization. In: Dondelinger RF, Rossi P, Kurdziel JC, Wallace S (eds) Interventional radiology. Thieme, Stuttgart, 314–324
Ellman BA, Parkhill BJ, Curry TS III, Marcus PB, Peters PC (1981) Ablation of renal tumor with absolute ethanol: a new technique. Radiology 141: 619–626
Schudrowitz L, Keller F (1990) Beidseitige Nierenarterien-embolisation wegen therapierefraktärem nephrotischen Syndrom. Internist 31: 717–718
Author information
Authors and Affiliations
Additional information
Correspondence to: M. Zwaan
Rights and permissions
About this article
Cite this article
Zwaan, M., Rinast, E., Perras, B. et al. Bilateral renal embolization as a therapy in proteinuria. Eur. Radiol. 5, 189–191 (1995). https://doi.org/10.1007/BF00171308
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00171308