Late kidney transplant dysfunction related to proximal aorto-iliac occlusive disease

This study is a retrospective analysis of a cohort of patients presenting with transplant renal dysfunction related to proximal aorto-iliac occlusive disease and treated with angioplasty and stenting. Primary outcomes included changes in intrarenal resistive index (RI) and laboratory and clinical data including serum creatinine level, systolic and diastolic blood pressure, and number of anti-hypertensive drugs before and after endovascular intervention. Secondary outcomes included overall patient and transplant kidney survival. Endovascular intervention was successful in all 26 included patients and associated with a significant increase in intrarenal RI in the upper pole (0.65 before vs. 0.74 after stent; P = 0.0009), in the interpolar region (0.64 before vs. 0.74 after stent; P = 0.0028), and in the lower pole (0.63 before vs. 0.76 after stent; P = 0.0002). In addition, there was a significant improvement in serum creatinine (2.29 mg/dL before vs. 1.49 mg/dL 6 weeks after stent; P < 0.0001) and systolic blood pressure (149.6 mmHg before vs. 139.8 mmHg 1 week after stent; P = 0.0233). Overall estimated transplant kidney survival was 95% at 5 and 10 years of follow-up. Endovascular intervention is a very effective and durable treatment option for the management of transplant renal dysfunction related to proximal aorto-iliac occlusive disease.