Renal artery stenosis due to fibromuscular dysplasia in a transplanted kidney from a deceased donor: a difficult diagnosis at color Doppler ultrasonography

J Clin Ultrasound. 2014 Feb;42(2):116-20. doi: 10.1002/jcu.22056. Epub 2013 May 9.

Abstract

Atherosclerotic renal artery stenosis is a frequent cause of arterial hypertension and/or allograft dysfunction after kidney transplantation and is usually located at the iliac artery anastomosis. Fibromuscular dysplasia is a less frequent, nonatherosclerotic, vascular disease, inducing stenosis at the proximal/mid-distal part of the renal artery. We report the case of a 44-year-old woman, in whom serum creatinine concentration increased and arterial hypertension developed 3 months after renal transplantation. Color Doppler ultrasonography showed a low arterial resistance index and prolonged acceleration time in the interlobar arteries, and a significantly increased peak systolic velocity at the mid third of the renal artery, demonstrating hemodynamically significant stenosis. Percutaneous transluminal angioplasty allowed stenosis correction and was followed by creatinine concentration and arterial blood pressure normalization.

Keywords: fibromuscular dysplasia; kidney transplantation; percutaneous transluminal angioplasty; renal artery stenosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Fibromuscular Dysplasia / diagnostic imaging*
  • Fibromuscular Dysplasia / etiology
  • Humans
  • Kidney Transplantation*
  • Postoperative Complications / diagnostic imaging*
  • Renal Artery Obstruction / diagnostic imaging*
  • Renal Artery Obstruction / etiology
  • Tissue Donors
  • Ultrasonography, Doppler, Color*