Bilateral Native Nephrectomy
The literature reports the benefits of bilateral native nephrectomy for treatment of resistant hypertension and many report a high rate of success (around 80%), which is not the case in our experience. What is your opinion; is it justifiable?

Alaa Gawish, FRCSEd

A generation ago, the standard pretransplant preparation was a bilateral native nephrectomy and splenectomy. As it turned out, splenectomy was associated with late sepsis and is no longer performed, and bilateral native nephrectomy is very rarely indicated these days. The currently available armamentarium of antihypertensive medications is sufficiently good that native nephrectomy is generally not necessary.