MANY AUTHORS consider uremia due to bilateral renal disease in its terminal stages as a contraindication to splanchnicectomy and sympathectomy.1 Patients with this condition are supposed to be inferior operative risks, and their chances of survival for more than a few years presumably are small. When medical measures fail, however, these fears should not prevail if relief can be obtained from agonizing headaches and loss of functional vision and if it can be shown that the operation can be performed with reasonable safety.
A bilateral splanchnicectomy and sympathectomy was performed in one stage by two operative teams on each of 10 patients with glomerular nephritis in the terminal stage. Their ages varied from 25 years to 36 years. All suffered from renal failure, with serum creatinine concentrations ranging from 2.22 to 8.75 mg. per hundred cubic centimeters. Their preoperative blood pressures averaged 235 systolic and 150 diastolic, the
EDWARD C. PERSIKE, RICHARD W. LIPPMAN, T. ADDIS, FREDERICK L. REICHERT, VICTOR RICHARDS. SURGICAL TREATMENT FOR HYPERTENSIVE COMPLICATIONS OF ADVANCED RENAL DISEASE. Arch Intern Med (Chic). 1949;83(3):348–354. doi:10.1001/archinte.1949.00220320102008