[Renal artery stenosis in the transplant patient].
OBJECTIVE
To present our experience in the diagnosis and treatment of renal artery stenosis in kidney transplants.


METHODS
A review of 601 renal transplants performed in adults showed 32 cases of renal artery stenosis. The diagnostic techniques utilized were arteriography in 18 patients, DIVAS in 15, echo-Doppler in 11 patients and MAG with captopril test on two occasions.


RESULTS
Arterial hypertension was the most common symptom (92.8%), alone (53.1%) or in association with impaired renal function (43.7%). 46.8% of the cases could be managed by drug therapy. Percutaneous transluminal angioplasty was performed in 14 patients. Surgery was required on two occasions.


CONCLUSIONS
The incidence of renal artery stenosis in our series of renal transplants in adults up to 1997 was 5.3%. Arterial hypertension with or without impairment of renal function was the most common symptom. Currently, echo-doppler and MAG with captopril test are the most widely utilized diagnostic techniques. Percutaneous transluminal angioplasty is the treatment of choice in renal artery stenosis when arterial hypertension is refractory to drug therapy. Good results are achieved in 57%, although it is not free from complications. In case of failure, revascularization surgery is the alternative approach.
Montañés Medina
P
P
Servicio de Urología, Hospital Universitario Virgen del Rocio, Sevilla, España.
Medina López
R A
RA
Torrubia Romero
F J
FJ
Domínguez Anguiano
M
M
Cruz Navarro
N
N
Rus Herrera
F
F
Muñoz Terol
J
J
Rocha Castilla
J L
JL
D000328:Adult; D000800:Angioplasty, Balloon; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D012086:Reoperation; D017211:Treatment Failure