The role of nephrectomy of the atrophic kidney in bearers of renovascular hypertension

Thomaz, Myrian J.; Lucon, Antônio Marmo; Praxedes, José Nery; Bortolotto, Luiz Aparecido; Srougi, Miguel

doi:10.1590/s1677-55382010000200005

Cited by 11 publications

(6 citation statements)

References 26 publications

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“…In present study, complete damaged kidney in one patient was removed and this was in accordance with Thomaz et al (20) who stated that in patients with renovascular hypertension nephrectomy of the atrophic kidney is a procedure which results in improvement of arterial hypertension and of the renal functions.…”

Section: Discussionsupporting

confidence: 87%

Surgical treatment of renovascular hypertension

Salem

et al. 2020

Zagazig University Medical Journal

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Background: Renovascular hypertension is the commonest form of secondary hypertension. It occurs in less than 5 % of all hypertensive population. There are two forms of renovascular hypertension: Atherosclerotic and fibromuscular dysplasia. Renovascular hypertension is suspected when it develops suddenly in patients under 30 or over 55 years of age, or abruptly worsen in any patient. The aim was to evaluate the indications of surgical treatment of "renovascular hypertension". Methods: Twenty cases with renovascular hypertension were included. The main investigations were: Laboratory studies, Duplex ultrasound, Intravenous pyelogram, CT angiography, aortography and selective renal angiography. Indications for surgery were : complex disease of the renal artery, aneurysm, accessory renal arteries, fibromuscular dysplasia and partial damaged of one kidney. Also, atherosclerotic stenosis of the renal arteries and complete kidney damage. Results : According to the etiology, 20 patients were divided into two groups : Group 1(Below 30 years)(Fibromuscular dysplasia group)which included 14 patients, (100.0%) were females, their age ranged from 18 to years with the mean±SD (24.7±3.5).Group 2(Above55 years)(Atherosclerotic group) which included 6 patients, their age ranged from 55 to 68 years with the mean±SD(62 ±4.1), 5(83.3%)were males and 1(16.7%) was female. Renal artery bypass graft was done for 15 cases, endarterectomy in 2 cases, endarterectomy with patch graft in two cases and nephrectomy in one case. Control of hypertension was successful in 17 cases, partial control of 2 cases, while the blood pressure still high in case of nephrectomy. No mortality in both groups within 6 months follow up period. Conclusions : Surgical treatment for renovascular hypertension is mandatory for complex disease of the renal artery, aneurysms and failure of endovascular procedures. Nephrectomy is the treatment of choice for damaged kidney.

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Section: Discussionsupporting

confidence: 87%

Surgical treatment of renovascular hypertension

Salem

et al. 2020

Zagazig University Medical Journal

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“…In general, laparoscopic surgery is known to have less postoperative pain, better cosmetic results, less blood transfusion, and shorter hospital stay compared to open surgery [14,15]. The improvement rates in BP control of patients after nephrectomy in our study were found to be similar to other studies conducted with adult patients in the literature (46.2% complete re- sponse, 19.8% partial response, and 34.0% no response) [4,5,12,16,17]. However, the predictive factors that can be used to decide which patient will benefit or not from nephrectomy are still unclear.…”

Section: Discussionsupporting

confidence: 87%

“…Although it was stated in many publications that nephrectomy is an effective method in the treatment of nephrogenic hypertension, the predictive factors to be used for the response to this treatment were not fully evaluated, perhaps due to the insufficient number of patients, or because a homogeneous patient group cannot be created [4,5,12,16,17]. According to the ordinal logistic regression analysis, we conducted in our study, male gender, duration of hypertension, presence of metabolic syndrome, and presence of preoperative systolic hypertension were defined as risk factors affecting the response to treatment (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors Affecting the Success of Nephrectomy for the Treatment of Nephrogenic Hypertension: Multicenter Study

et al. 2021

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Introduction: The aim of our study is to evaluate the predictive factors affecting the success of treatment with nephrectomy in patients with poorly functioning kidney and nephrogenic hypertension. Methods: Data for patients who underwent nephrectomy with a diagnosis of nephrogenic hypertension in 3 centers between May 2010 and January 2020 were analyzed. In the postoperative period, if the blood pressure (BP) was below 140/90 mm Hg without medical treatment, it was accepted as complete response; if the arterial BP was below 140/90 mm Hg with medical treatment or less medication, it was accepted as partial response; and if BP did not decrease to normal values, it was accepted as unresponsive. Demographic characteristics, duration of hypertension, preoperative and postoperative BP values, and presence of metabolic syndrome were statistically evaluated. Results: Our study consisted of 91 patients with a mean preoperative hypertension duration of 23.3 ± 12.1 months. Among patients, 42 (46.2%) had complete response, 18 (19.8%) had partial response, and 31 (34.0%) had no response. Preoperative systolic and diastolic BP values were not effective on treatment success (p = 0.071, p = 0.973, respectively), but the increase in age and hypertension duration (p = 0.030 and p < 0.001, respectively) and the presence of metabolic syndrome (p = 0.002) significantly decreased the complete response rates. Conclusions: Preoperative hypertension duration, advanced age, and presence of metabolic syndrome are predictive factors affecting the response to treatment in patients who undergo nephrectomy due to nephrogenic hypertension.

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“…A UPJ obstruction is a congenital disease that may result in the development of hydronephrosis and kidney function loss (9). Depending on the nature of the UPJ obstruction, the stone incidence rate is approximately 20% (10).…”

Section: Discussionmentioning

confidence: 99%

Laparoskopik Pyeloplasti Ve Pyelolitotomi Operasyonlarında Taş Çıkarılmasında Fleksible Sistoskop Kullanımı

Bitkin¹,

Aydın²,

Akgüneş³

et al. 2019

Yeni Üroloji Dergisi

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Objective: Laparoscopic pyeloplasty and laparoscopic pyelolithotomy are widely used in the treatment of ureteropelvic junction (UPJ) obstructions and renal stones in the urology field. Flexible cystoscopy can be used simultaneously with these methods for removal of calyceal stones in patients with UPJ obstructions. The present study assessed the usefulness of these surgical procedures. Material and Methods: Between February 2016 and October 2017, 7 patients underwent stone removal with a flexible cystoscope during laparoscopic pyelolithotomy and laparoscopic pyeloplasty. The durations of the operations and hospital stays, blood loss, preoperative and postoperative complications, and follow-up times were evaluated. Results: Five of seven patients had renal stones with UPJ obstruction. Two patients had calyceal stones in the lower calyx , in addition to renal pelvic stones. The mean age of the patients was 36.8 (18-73) years. The stone-free rate was 85.7%. The mean duration of the operation was 153.5 (105-230) min, and the duration of the hospital stay was 4.4 (3-7) days. There were no intraoperative or postoperative complications. Conclusion: Laparoscopic pyeloplasty and pyelolithotomy, with simultaneous use of flexible cystoscopy in UPJ obstruction patients with kidney stones and patients with multiple renal stones is a feasible treatment option, with a high success rate.

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The role of nephrectomy of the atrophic kidney in bearers of renovascular hypertension

Cited by 11 publications

References 26 publications

Surgical treatment of renovascular hypertension

Surgical treatment of renovascular hypertension

Predictive Factors Affecting the Success of Nephrectomy for the Treatment of Nephrogenic Hypertension: Multicenter Study

Laparoskopik Pyeloplasti Ve Pyelolitotomi Operasyonlarında Taş Çıkarılmasında Fleksible Sistoskop Kullanımı

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