LONG-TERM CONTROL OF HYPERTENSION AND THE PREDICTIVE VALUE OF PERIPHERAL PLASMA-RENIN ACTIVITY AFTER ABLATION OF END-STAGE KIDNEYS WITH A NEW EMBOLIC AGENT

Embolization of end-stage kidneys using our own embolizing agent Vilan ol (partially hydrolyzed polyvinyl acetate) was performed in 10 patien ts with hypertension refractory to conservative therapy. Native kidney s were embolized in 7 patients with chronic renal failure, nonfunction ing renal transplants in 2 patients, and a shrunken kidney in 1 patien t. Five of the 10 patients had high (9.96-18.2 ng/ml/h) peripheral ren in (PR) levels. The embolization was technically successful in 4 of th ese 5 patients and was immediately followed by a marked decrease in PR , and simultaneous improvement in blood pressure (BP). The other 5 pat ients had very low PR levels (0.07-0.65 ng/ml/h), and a reduction in B P was observed in 4 after embolization. One patient died following emb olization from cardiac arrest due to hyperkalemia. Six patients (3 in each group) have been on follow-up for 2-5 years with sustained decrea se in BP. We conclude that the new agent is effective for renal ablati on and control of refractory hypertension.