Medical nephrectomy: the use of metallic salts for treatment of end stage massive proteinuria and renal hypertension.

ABSTRACT

The first two cases outlined above with intractable massive proteinuria and uremia, were followed and treated with standard medical therapy and dialysis. After a period of study and demonstration of clinical deterioration both patients were given solutions containing sodium mercaptomerin. Within days there was a decline in urine protein excretion and a variable increase in serum protein concentration. The patients demonstrated an increase in blood pressure, which made hemodialysis treatment possible. No deleterious effects from the mercury salts were noted. These observations suggest that in selected cases nephrotoxic agents may be of value in decreasing massive proteinuria, and improving protein homeostasis in uremic patients. The ideal agent should be non-toxic to other organs and produce selective renal ablation (15). Although mercury is not the ideal agent, in these cases it did not produce observable side effects. This new method, applicable to dialysis patients with massive proteinuria, and of help in the control of uncontrollable hypertension in uremia, is an interesting new approach for our therapeutic armamentarium.