LAPAROSCOPIC BILATERAL-NEPHRECTOMY FOR RENIN-MEDIATED HYPERTENSION

Hypertension arising from retained native kidneys complicates the mana gement of recipients of renal transplants. Reluctance to administer an giotensin-converting enzyme inhibitor (ACEI) drugs to patients taking cyclosporine has reopened the question of performing native nephrectom ies for poorly controlled, renin-dependent hypertension. We report the first published cases of simultaneous bilateral laparoscopic nephrect omies in 2 patients: 1 in preparation for living-related donor transpl antation, and the other ten months following cadaver transplantation i n a patient whose end-stage renal disease was from malignant nephroscl erosis. Both had very severe hypertension resistant to multiple drugs and both became normotensive with little or no antihypertensive medica tion following nephrectomies. A bilateral nephrectomy is currently fea sible using a laparoscopic approach.