Artery stenosis of the renal graft : experience of a center of northeastern Brazil

Abstract

Background. Transplant renal artery stenosis (TRAS), the most common vascular complication after transplant (Tx), leads to resistant hypertension, impaired renal function, and even loss of the graft. The purpose of the study was to investigate the prevalence and factors associated with TRAS in northeastern Brazil. Methods. The study was conducted as a retrospective case-control study in a population of Tx recipients in a renal Tx center in northeastern Brazil. Demographic and clinical characteristics of the recipients and donors, data related to the surgery, laboratory data, and number of anti-hypertensive drugs were assessed. Statistical analysis was performed with the use of SPSS 17.0. Results. A total of 494 of 529 recipients were assessed, of which 24 had TRAS. The prevalence of TRAS was 4.8%. Twelve patients (50%) were men with a mean age of 46.7

13.5 years. The mean time of diagnosis was 89.9 days after Tx. The risk factors associated with TRAS were number of anti-hypertensive drugs

2 (odds ratio, 17.0; con fi dence interval, 4.1 to 70.4; P ¼ .001) and grafting with 2 or more arteries (odds ratio, 8.9; con fi dence interval, 1.4 to 56.6; P ¼ .021). There was a signi fi cant reduction in mean systolic blood pressure (147.1

23.7 to 127.8

15.2 mm Hg, P ¼ .001) and diastolic blood pressure (86.6

13.0 to 77.6

9.4 mm Hg, P ¼ .001) after TRAS repair and in serum creatinine (2.8

2.4 to 1.9

1.8 mg/dL, P ¼ .04). Conclusions. Grafts with 2 or more arteries are associated with TRAS, as well as patients who use a higher number of anti-hypertensive drugs. TRAS repair was associated with improved blood pressure control and renal function.