Kosin Med J.  2019 Dec;34(2):168-172. 10.7180/kmj.2019.34.2.168.

Aortoiliac Occlusive Disease as a Cause of Allograft Kidney Dysfunction and Refractory Hypertension

Affiliations
  • 1Department of surgery, Seoul Paik hospital, Inje University, Korea. Jin.theDoc@gmail.com

Abstract

Aortoiliac occlusive disease (AIOD), especially proximal to the transplant artery, in kidney transplant patient activates the renin-angiotensin-aldosterone system by limiting graft renal perfusion and causes symptoms that can occur with transplant renal artery stenosis (TRAS) such as refractory hypertension, water retention, and graft renal dysfunction. Immediate clinical suspicion is difficult due to the nature of the progressive disease unlike TRAS. Herein, we present an interesting case of bilateral common iliac artery occlusion (AIOD, TASC II, type C) that manifested as uncontrolled blood pressure and decreased allograft function in a patient who had kidney transplant 17 years ago. The patient was successfully diagnosed with duplex scan, ankle-brachial index (ABI) and computed tomography angiography and treated with percutaneous luminal angioplasty and stent graft insertion.

Keyword

Allograft dysfunction; Common iliac artery; Kidney transplantation; Refractory hypertension

MeSH Terms

Allografts*
Angiography
Angioplasty
Ankle Brachial Index
Arteries
Blood Pressure
Blood Vessel Prosthesis
Humans
Hypertension*
Iliac Artery
Kidney Transplantation
Kidney*
Perfusion
Phenobarbital
Renal Artery Obstruction
Renin-Angiotensin System
Transplants
Water
Phenobarbital
Water
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