title: Reversible renal allograft dysfunction and proteinuria from nutcracker-like syndrome: a case report.
abstract: A 27-year-old Hispanic man with hypertension and renal failure was on hemodialysis for 4 years prior to receiving a living donor renal transplant from his 19-year-old sister. His serum creatinine decreased to 1.7 mg/dL at 3 weeks posttransplant with a urine protein creatinine ratio (UP) of 0.1 (g/g). Over the next 2 months, he experienced repeated episodes of allograft dysfunction with elevation of creatinine and proteinuria levels, associated with a lymphocele. Doppler studies of the allograft revealed renal vein compression. His symptoms responded to aspiration of the fluid collection, resolving completely with surgical drainage. We believe that the episodes of allograft dysfunction and proteinuria were related to recurrent lymphocele, causing a nutcracker-like syndrome.
authors.affiliation: Division of Kidney Diseases/Hypertension, North Shore University Hospital, 100 Community Drive, Great Neck, NY 11021, USA.
authors.forename: S G S
authors.initials: SG
authors.lastname: Krishnan
authors.forename: J
authors.initials: J
authors.lastname: Pritsiolas
authors.forename: M
authors.initials: M
authors.lastname: Susin
authors.forename: E
authors.initials: E
authors.lastname: Linden
authors.forename: E
authors.initials: E
authors.lastname: Beil-Levi
authors.forename: M
authors.initials: M
authors.lastname: Gitman
authors.forename: R
authors.initials: R
authors.lastname: Mossey
authors.forename: M
authors.initials: M
authors.lastname: Bhaskaran
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D011507:Proteinuria / Q000209:etiology*; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler