Transplant renal artery stenosis: Clinical manifestations, diagnosis and therapy

Wei Chen, Liise K. Kayler, Martin S. Zand, Renu Muttana, Victoria Chernyak, Graciela O. Deboccardo

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Transplant renal artery stenosis (TRAS) is a well-recognized vascular complication after kidney transplant. It occurs most frequently in the first 6 months after kidney transplant, and is one of the major causes of graft loss and premature death in transplant recipients. Renal hypoperfusion occurring in TRAS results in activation of the renin-angiotensin-aldosterone system; patients usually present with worsening or refractory hypertension, fluid retention and often allograft dysfunction. Flash pulmonary edema can develop in patients with critical bilateral renal artery stenosis or renal artery stenosis in a solitary kidney, and this unique clinical entity has been named Pickering Syndrome. Prompt diagnosis and treatment of TRAS can prevent allograft damage and systemic sequelae. Duplex sonography is the most commonly used screening tool, whereas angiography provides the definitive diagnosis. Percutaneous transluminal angioplasty with stent placement can be performed during angiography if a lesion is identified, and it is generally the first-line therapy for TRAS. However, there is no randomized controlled trial examining the efficacy and safety of percutaneous transluminal angioplasty compared with medical therapy alone or surgical intervention.

Original languageEnglish (US)
Pages (from-to)71-78
Number of pages8
JournalClinical Kidney Journal
Volume8
Issue number1
DOIs
StatePublished - Dec 18 2014

Fingerprint

Renal Artery Obstruction
Transplants
Kidney
Angioplasty
Therapeutics
Allografts
Angiography
Premature Mortality
Pulmonary Edema
Renin-Angiotensin System
Stents
Blood Vessels
Ultrasonography
Randomized Controlled Trials
Hypertension
Safety

Keywords

  • flash pulmonary edema
  • hypertensive crisis
  • Pickering syndrome
  • renal artery pseudoaneurysm
  • transplant renal artery stenosis

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Transplant renal artery stenosis : Clinical manifestations, diagnosis and therapy. / Chen, Wei; Kayler, Liise K.; Zand, Martin S.; Muttana, Renu; Chernyak, Victoria; Deboccardo, Graciela O.

In: Clinical Kidney Journal, Vol. 8, No. 1, 18.12.2014, p. 71-78.

Research output: Contribution to journalArticle

Chen, Wei ; Kayler, Liise K. ; Zand, Martin S. ; Muttana, Renu ; Chernyak, Victoria ; Deboccardo, Graciela O. / Transplant renal artery stenosis : Clinical manifestations, diagnosis and therapy. In: Clinical Kidney Journal. 2014 ; Vol. 8, No. 1. pp. 71-78.
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