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Renal artery embolization in severe nephrotic syndrome
Authors:Yalcin Solak  Osman Koc  Ramazan Ucar  Orhan Ozbek  Hasan Ergenc  Abduzhappar Gaipov  Suleyman Turk
Affiliation:1. Nephrology Division, Department of Internal Medicine, Sakarya University Research and Training Hospital, Sakarya, Turkey;2. Department of Radiology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey;3. Department of Internal Medicine, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey;4. Department of Internal Medicine, Sakarya University Research and Training Hospital, Sakarya, Turkey;5. Department of Extracorporeal Hemocorrection, National Scientific Medical Center, Astana, Kazakhstan;6. Nephrology Division, Department of Internal Medicine, Selcuk University, Konya, Turkey
Abstract:Introduction Severe nephrotic syndrome is associated with increased morbidity and mortality. Renal artery embolization (RAE) has been used in a number of renal diseases such as renal tumors, arteriovenous fistulas etc. However, data regarding benefits of RAE in patients with symptomatic severe proteinuria is limited. We decided to evaluate role of RAE in the setting of severe symptomatic nephrotic syndrome. Methods Eight patients who had undergone transcatheter renal artery embolization with polyvinyl alcohol (PVA) were included. Clinico‐demographic characteristics as well as baseline laboratory data including level of proteinuria, serum albumin, C‐reactive protein and LDL cholesterol levels were recorded for each patient. After RAE, outpatient clinic control laboratory values were also assessed. Findings All patients except one underwent bilateral RAE (four simultaneous or three sequential). Two patients experienced postembolization syndrome characterized by flank pain, fever, and leukocytosis, which was self‐limited and responded to analgesics in all patients. There was no technical complications associated with RAE procedure. All patients became anuric except one. Serum albumin levels increased and serum LDL‐cholesterol levels decreased considerably in treated patients. Discussion Renal artery embolization with the purpose of amelioration in nephrotic syndrome complications was effective and free of major technical complications in our patients.
Keywords:Amyloidosis  proteinuria  hypoalbuminemia  renal artery embolization  medical nephrectomy  nephrotic syndrome
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