| Long-term outcome of transplant renal artery stenosis managed conservatively or by radiological intervention. | |
| | |
MedLine Citation:
|
PMID: 18435786 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The natural history and optimal treatment of transplant renal artery stenosis (TRAS) is poorly defined. Few studies reported long-term clinical outcomes. A single centre analysis of 43 patients diagnosed with TRAS 1990-2003 was performed. Twenty-seven had percutaneous intervention (including 10 patients who had >1 intervention) and 16 were managed conservatively at the discretion of the attending clinicians. Transplant function was assessed by slope of estimated glomerular filtration rate (eGFR) over five yr of follow-up. Patients in the intervention group had lower mean eGFR (36.3 mL/min/1.73 m(2) vs. 46.3 mL/min/1.73 m(2); p = 0.07) at baseline. Five transplants in the intervention group failed (including two as a direct result of intervention) and one in the conservative group failed. There was no significant difference in the rate of deterioration in renal function (mean slope of eGFR minus 0.8 mL/min/yr and minus 1.0 mL/min/yr in the intervention and conservative groups, respectively; p = 0.79). There was no significant difference in blood pressure or number of anti-hypertensive agents between the groups at any time point. Baseline Doppler ultrasound indices showed no significant correlation with slope of eGFR in either group. Our data demonstrate that selected patients with TRAS can be managed without intervention and that this approach is associated with good long-term outcome. Selection of appropriate patients for intervention remains difficult and larger randomized studies are required. |
| | |
Authors:
|
Colin C Geddes; Siobhan K McManus; Shiva Koteeswaran; Grant M Baxter |
Related Documents
:
|
7160976 - Subglottic stenosis. 18827196 - An 82-year-old woman with worsening hypertension: review of renal artery stenosis. 17174736 - Multislice ct-angiography in percutaneous postinterventional hematuria and kidney bleed... 15767996 - Fenestrated endovascular grafting: the renal side of the story. 7760206 - Major gastrointestinal bleeding occurring after liver transplantation. 7816286 - Colour-coded doppler sonography in monitoring native kidney biopsies. |
Publication Detail:
|
Type: Comparative Study; Journal Article Date: 2008-04-23 |
Journal Detail:
|
Title: Clinical transplantation Volume: 22 ISSN: 1399-0012 ISO Abbreviation: Clin Transplant Publication Date: 2008 Sep-Oct |
Date Detail:
|
Created Date: 2008-10-07 Completed Date: 2009-03-25 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8710240 Medline TA: Clin Transplant Country: Denmark |
Other Details:
|
Languages: eng Pagination: 572-8 Citation Subset: IM |
Affiliation:
|
Department of Renal Medicine, Western Infirmary, Glasgow, Scotland, UK. colin.geddes@northglasgow.scot.nhs.uk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Angioplasty* Female Follow-Up Studies Glomerular Filtration Rate Humans Kidney Transplantation / adverse effects* Male Middle Aged Predictive Value of Tests Pulsatile Flow Renal Artery Obstruction / etiology, surgery*, ultrasonography Stents* Survival Analysis Thrombosis / etiology, surgery*, ultrasonography Ultrasonography, Doppler, Color |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Functional analysis of CD4+ CD25bright T cells in kidney transplant patients: improving suppression ...
Next Document: Nocardia infection in lung transplant recipients.