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Kidney Week

Abstract: PO0113

Glomerular Congestion Secondary to Renal Vein Stenosis After Kidney Transplant

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Author

  • Alnimri, Muna, University of California Davis Department of Internal Medicine, Sacramento, California, United States
Introduction

Renal vein stenosis ( RVS) post kidney transplant is uncommon complication, especially when it causes severe glomerular congestion, and AKI
We present a case of RVS 3 months post kidney transplant with kidney biopsy showing severe glomerular congestion

Case Description

33 y old male CKD secondary to HTN underwent LKT, smooth post op course discharged with a creatinine of 1.1mg/dl presented for 3 months protocol biopsy with creatinine of 1.5mg/dl, kidney biopsy showed severe glomerular congestion No rejection figure1, Doppler US showed suspicion for renal vein stenosis. Renal venogram demonstrated narrowing of the transplant renal vein at the anastomosis with the right common iliac vein figure 2
Successful 10 mm angioplasty balloon was inflated along the narrowed segment follow up creatinine back to 1.1mg/dl

Discussion

Transplant RVS is a rare vascular complication after renal transplantation that may cause graft dysfunction. Correction of RVS with either angioplasty or stent placement is safe and effective approach. Our patient presneted with AKI and severe glomerular congestion that warranted doppler US ,the finding of RVS and glomerular congestion from back pressure warranted urgent venogram and angioplasty with excellent results .
Conclusion : in evaluating AKI post kidney transplant ureteral obstruction, rejection ,CNI toxicity and renal artery stenosis should be ruled out if all negative RVS should be evaluated

Glomerular congestion on kidney biopsy

Renal vein stenosis with post stenosis dilation