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Bilateral nephrectomy was performed in 53 patients on regular haemodialysis. The indications were pyelonephritis in 30, polycystic kidneys in 6, glomerulnephritis in 7, uncontrollable hypertension in 9 and horseshoe kidney in 1. In 87 per cent of cases the operation was carried out as a separate procedure prior to transplantation. The mortality was 9 per cent and the postoperative complications included hypotension, clotting of arteriovenous shunts, pneumonia and subphrenic abscess. As a result of our experience we have revised our indications for bilateral nephrectomy which now are pyelonephritis only when associated with persistent bacteriuria or ureteric reflux, polycystic kidneys and uncontrollable hypertension.

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