Abdominal bruit after renal transplantation

Area of Science:

• Nephrology
• Transplant Surgery
• Vascular Surgery

Background:

• Renal artery bruit is a potential indicator of vascular complications post-kidney transplantation.
• Early detection and prognostic significance of renal artery bruit require further investigation.

Purpose of the Study:

• To evaluate the diagnostic and prognostic value of renal artery bruit in renal allograft recipients.
• To correlate the presence and behavior of renal artery bruit with allograft function and vascular stenosis.

Main Methods:

• Prospective study of 47 renal allograft recipients.
• Auditory examination for renal artery bruit at varying post-transplant intervals.
• Correlation of bruit findings with renal function (serum creatinine, GFR) and blood pressure.
• Arteriography performed in select cases to confirm allograft artery stenosis.

Main Results:

• Renal artery bruit was detected in 8/16 patients within two months post-transplant; four of these bruits resolved spontaneously.
• Disappearance of bruit correlated with impaired renal function.
• In patients examined >2 months post-transplant, 10 had audible bruits; 9 were hypertensive, and 5/6 with arteriography showed allograft artery stenosis.
• Only 8/37 patients without bruit were hypertensive, and arteriography revealed no stenosis in 10 normotensive patients without bruit.

Conclusions:

• A renal artery bruit in the early post-transplant period may indicate good initial renal blood flow.
• Persistent bruit suggests significant allograft artery stenosis, predicting a poor long-term prognosis.
• Disappearance of a renal artery bruit is associated with compromised renal function, also indicating a poor outlook.