Incidence and outcome of transplant renal artery stenosis: A single-center experience

Abstract

Introduction: Transplant renal artery stenosis (TRAS) is a recognized, potentially curable cause of posttransplant arterial hypertension, allograft dysfunction, and graft loss. Aim: This study aims to study the incidence, clinical presentation, and outcome of TRAS in renal allograft recipients. Materials and Methods: This is a retrospective study done at the Institute of Nephrology, Madras Medical College, from January 2009 to November 2016. Demographic data, type of renal donor, and posttransplant evaluation including delayed graft dysfunction, acute rejection, cytomegalovirus status, blood pressure profile, and graft function were studied. Laboratory and investigation data including serum potassium, lipid profile, Doppler transplant renal artery, and angiogram were analyzed. Results: Five hundred and twenty-six renal allograft recipients were studied; 7 patients had TRAS (1.3%). The timeline of TRAS ranged from 3 to 30 months (median: 5 months) after transplant. Three patients (42%) presented with refractory hypertension, six (85%) patients developed allograft dysfunction, and three (42%) patients presented with anuria. All patients were treated with percutaneous transluminal angioplasty with stenting, and one patient had recurrent TRAS after 1 year and treated with balloon angioplasty and stenting. Among seven patients, three patients have normal graft function, three had chronic graft dysfunction, and one patient had graft loss. Conclusion: The incidence of TRAS in the study was 1.3%. Early detection and correction reduce patients morbidity and allograft dysfunction.