Long-term follow-up of renal transplant patients with renal artery stenosis treated by percutaneous angioplasty.
OBJECTIVE
To evaluate if renal angioplasty (PTRA) in patients with transplanted kidney and renal artery stenosis (TRAS) can have long-term effect on hypertension and renal function.


METHODS
Within a 24-year time period, 58 PTRAs in 55 adults (three times Re-PTRA) with transplanted kidney were performed. The group included 34 males and 21 females, average age 41+/-10.6 (18-72) years. After exclusion of 7 technical failures, 51 PTRAs were followed at 1 week, 6 months and 1-3 years after PTRA. Hypertension improvement was defined as mean arterial pressure (MAP) decrease of at least 15% from the pre-PTRA value. Graft function was evaluated by serum creatinine (Scr) and creatinine clearance (Ccr) levels, and the improvement was defined as a 20% change. Clinical FU was 3 years.


RESULTS
PTRA technical success was 88.4%. In 51 kidney recipients at the end of FU, blood pressure improved in 65.2% of patients (MAP decreased from 123+/-13.1 to 107+/-12.1 mmHg), but no patient remained normotensive medication free. Graft function improved in 44.8% of patients and was stabilized in 20.7% of them (average Ccr before PTRA: 0.48+/-0.29, after PTRA: 0.78+/-47 ml/s). PTRA complications were observed in 25.5% of procedures, most often with no clinical sequel. Thirty days mortality was 1.8% (one patient).


CONCLUSIONS
PTRA results in kidney recipients are valuable mainly in preserving graft function.
Peregrin
Jan H
JH
Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Vídenská 1958/9, 14021 Prague 4, Czech Republic. jape@medicon.cz
Stríbrná
Jarmila
J
Lácha
Jirí
J
Skibová
Jelena
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000792:Angiography; D000800:Angioplasty, Balloon; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome