2 MASQUERADERS OF TRANSPLANT RENAL-ARTERY STENOSIS (TRAS)

Seven patients presented after kidney transplantation with hypertensio n and creatinine elevation. Only 4 of 7 (57%) had a discernible bruit. Four had iliac stenosis proximal to the transplant renal artery and 3 had biopsy-induced parechymal AV fistulae. All stenoses were successf ully balloon-dilated. Two of the A-V fistulae were corrected with coil embolization. In general, treatment for both of these conditions stab ilized the blood pressure, although most patients remained on some ant ihypertensive medication. The creatinine also stabilized after treatme nt. We believe patients with proximal iliac artery stenosis should be treated with balloon angioplasty and parenchymal A-V fistula with coil embolization to allow stabilization of blood pressure and prevent fur ther deterioration in renal function.