Common iliac artery stenosis presenting as renal allograft dysfunction in two diabetic recipients.
BACKGROUND
Suprarenal common iliac artery stenosis is an uncommon but reversible cause of allograft dysfunction in renal transplant recipients.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Aslam
S
S
Department of Medicine, State University of New York Health Sciences Center at Brooklyn, 11203, USA.
Salifu
M O
MO
Ghali
H
H
Markell
M S
MS
Friedman
E A
EA
D000328:Adult; D001157:Arterial Occlusive Diseases / Q000175:diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007083:Iliac Artery; D016031:Liver Transplantation / Q000473:pathology; D008297:Male