Common iliac artery stenosis presenting as renal allograft dysfunction in two diabetic recipients

Background. Suprarenal common iliac artery stenosis is an uncommon but reve rsible cause of allograft dysfunction in renal transplant recipients. Method. We describe two diabetic renal transplant recipients with worsening hypertension, edema, and azotemia, Magnetic resonance angiography (MRA) de monstrated tight stenoses in the common iliac artery proximal to the allogr aft anastomosis site with patent renal transplant artery in both cases. The se findings were later confirmed with carbon dioxide angiography. Results. No acute rejection was noted on renal biopsy in either case. Place ment of percutaneous iliac artery Wallstents resulted in decrease of serum creatinine from 6.5 to 2.0 mg/dl and 1.7 to 1.0 mg/dl within 2 and 4 weeks, respectively. Conclusion. Common iliac artery stenosis should be suspected in renal trans plant recipients presenting with worsening hypertension, edema and azotemia . MRA for screening followed by carbon dioxide angiography and placement of intravascular stents for focal vascular obstructive lesions reverses allog raft dysfunction.