European Radiology

, Volume 5, Issue 2, pp 189–191 | Cite as

Bilateral renal embolization as a therapy in proteinuria

  • M. Zwaan
  • E. Rinast
  • B. Perras
  • C. Kagel
  • H. -D. Weiss
Case reports Cardiovascular radiology

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.

Key words

Nephrotic syndrome Proteinuria Renal ablation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Greenstein AJ, Janowitz HD, Sachar DB (1976) The extraintestinal complication of Crohn's disease and ulcerative colitis: a study of 700 patients. Medicine 55: 401–407PubMedGoogle Scholar
  2. 2.
    Steinhoff J, Schulz E, Herbst EW, Fricke L, Sack K (1988) Therapie der Amyloidnephrose bei Morbus Crohn: Plasmapherese plus Azathioprin? Wien Med Wochenschr 138: 49–54PubMedGoogle Scholar
  3. 3.
    Westermark P, Sletten K, Erikson M (1979) Morphologic and chemical variation of kidney lesions in amyloidosis secondary to rheumatoid arthritis. Lab Invest 41: 427–431PubMedGoogle Scholar
  4. 4.
    Banowsky LH (1976) The role of adjuvant operations in renal transplantation. Urol Clin North Am 3: 527–551PubMedGoogle Scholar
  5. 5.
    Mitchell TS, Halasz NA, Gittes GF (1973) Renal transplantation: selective preliminary bilateral nephrectomy. J Urol 109: 796–801PubMedGoogle Scholar
  6. 6.
    Sheinfeld J, Linke CL, Talley TE, Linke CA (1985) Selective pre-transplant nephrectomy: indications and perioperative management. J Urol 133: 379–382PubMedGoogle Scholar
  7. 7.
    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: 447–451PubMedGoogle Scholar
  8. 8.
    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: 652PubMedGoogle Scholar
  9. 9.
    Lowenstein J, Gallo G (1970) Remission of the nephrotic syndrome in renal amyloidosis. N Engl J Med 282: 128–130PubMedGoogle Scholar
  10. 10.
    Lytton B (1986) Surgery of the kidney. In: Walsh PC, Gittes RF, Perlmutter AD, Stamey TA (eds) Cambell's urology. Saunders, Philadelphia, 2406–2453Google Scholar
  11. 11.
    Dotter CT, Goldman ML, Rosch J (1975) Instant selective arterial occlusion with isobutyl-2-cyanoacrylate. Radiology 114: 227–230PubMedGoogle Scholar
  12. 12.
    Henrich WL, Goldman M, Dotter CT, Rosch J, Bennett WM (1996) Therapeutic renal arterial occlusion for elimination of proteinuria. Arch Intern Med 136: 840–842Google Scholar
  13. 13.
    Wu MJ, Moorthy AV, Beirne GJ, Crummy AB (1980) Renal ablation with Gianturco wool coils. JAMA 243: 2425–2426PubMedGoogle Scholar
  14. 14.
    Nanni GS, Hawkins IF Jr, Orak JK (1983) Control of hypertension by ethanol renal ablation. Radiology 148: 51–54PubMedGoogle Scholar
  15. 15.
    Lieberman SF, Keller FS, Pearse HD, Fuchs EF, Rosch J, Barry JM (1983) Percutaneous vaso-occlusion for nonmalignant renal lesions. J Urol 129: 805–809PubMedGoogle Scholar
  16. 16.
    Novak D (1990) Complications of arterial embolization. In: Dondelinger RF, Rossi P, Kurdziel JC, Wallace S (eds) Interventional radiology. Thieme, Stuttgart, 314–324Google Scholar
  17. 17.
    Ellman BA, Parkhill BJ, Curry TS III, Marcus PB, Peters PC (1981) Ablation of renal tumor with absolute ethanol: a new technique. Radiology 141: 619–626PubMedGoogle Scholar
  18. 18.
    Schudrowitz L, Keller F (1990) Beidseitige Nierenarterien-embolisation wegen therapierefraktärem nephrotischen Syndrom. Internist 31: 717–718PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • M. Zwaan
    • 1
  • E. Rinast
    • 1
  • B. Perras
    • 2
  • C. Kagel
    • 1
  • H. -D. Weiss
    • 1
  1. 1.Department of RadiologyMedical University of LübeckLübeckGermany
  2. 2.Medical ClinicMedical University of LübeckLübeckGermany

Personalised recommendations