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

Cardiovasc Intervent Radiol. 1993 Nov-Dec;16(6):355-60. doi: 10.1007/BF02603140.

Abstract

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

MeSH terms

  • Adult
  • Blood Pressure
  • Embolization, Therapeutic*
  • Female
  • Humans
  • Hypertension, Renal / physiopathology
  • Hypertension, Renal / therapy*
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Polyvinyls*
  • Renal Artery*
  • Renin / blood*

Substances

  • Polyvinyls
  • Vilanol
  • Renin