Common iliac artery stenosis presenting as renal allograft dysfunction in two diabetic recipients

Transplantation
S AslamE A Friedman

Abstract

Suprarenal common iliac artery stenosis is an uncommon but reversible cause of allograft dysfunction in renal transplant recipients. We describe two diabetic renal transplant recipients with worsening hypertension, edema, and azotemia. Magnetic resonance angiography (MRA) demonstrated tight stenoses in the common iliac artery proximal to the allograft anastomosis site with patent renal transplant artery in both cases. These findings were later confirmed with carbon dioxide angiography. No acute rejection was noted on renal biopsy in either case. Placement of percutaneous iliac artery Wallstents resulted in decrease of serum creatinine from 6.5 to 2.0 mg/dl and 1.7 to 1.0 mg/dl within 2 and 4 weeks, respectively. Common iliac artery stenosis should be suspected in renal transplant recipients presenting with worsening hypertension, edema and azotemia. MRA for screening followed by carbon dioxide angiography and placement of intravascular stents for focal vascular obstructive lesions reverses allograft dysfunction.

References

Sep 1, 1992·Cardiovascular and Interventional Radiology·D Vorwerk, R W Günther
Mar 1, 1991·RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin·H StrunkM Thelen
Feb 29, 2000·Clinical Transplantation·R S KoushikM E Rosenberg

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Citations

Jul 16, 2008·Current Diabetes Reports·Moro O SalifuSamy I McFarlane
May 26, 2005·Current Hypertension Reports·Moro O SalifuSamy I McFarlane
Jul 1, 2008·Transplantation Proceedings·P PappasA Kostakis
Aug 27, 2015·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Ana Patricia González-CáceresRicardo Lauzurica
Jul 10, 2007·The Journal of Clinical Hypertension·Fasika TedlaMoro O Salifu
Jul 3, 2020·Frontiers in Medicine·Ekamol TantisattamoAlpesh Amin

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