Risk factors of transplant renal artery stenosis in kidney transplant recipients

Kanhouche, Gabriel; Santos, Gianni Mara Silva dos; Orellana, Henry Campos; Galhardo, Attílio; Faccinetto, Ana Carolina Buso; Barteczko, Manoela Linhares Machado; Carvalho, Luiz Sérgio F.; Taddeo, Julia Bernardi; Foresto, Renato Demarchi; Moisés, Valdir Ambrósio; Tedesco‐Silva, Hélio; Pestana, José Medina; Barbosa, Adriano Henrique Pereira

doi:10.1016/j.clinsp.2022.100087

Cited by 6 publications

(4 citation statements)

References 17 publications

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“…Thus, as well as in the adult population, as evidenced in the study by Rengel et al and other studies, TRAS was the main cause of hypertension in this group of children and adolescents [3,14].…”

Section: Discussionsupporting

confidence: 63%

“…Despite the fact that steroid-resistant nephrotic syndrome is currently an important cause of progressive kidney disease, we had no cases in our sample [20,21]. The findings of our study and the pediatric and the adult population from the literature the benefits of percutaneous treatment were similar on both: TRAS group (intervention) showed similar evolutions with percutaneous treatment, such as an improvement in blood pressure levels, renal graft survival, decrease in the number of antihypertensive drugs [1][2][3][4]6,7,14,[16][17][18][19]22,23].…”

Section: Plos Onementioning

confidence: 68%

“…In the adult population, the main indication for renal transplant was complications from diabetes as demonstrated in the study by Kanhouche G. et.al [14]. Among children and adolescents (Table 1), the main indication for kidney transplantation was genitourinary system malformation, and the second indication was undetermined.…”

Section: Discussionmentioning

confidence: 92%

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Retrospective analysis of percutaneous intervention of the renal artery in transplanted kidneys in children and adolescents at a tertiary public hospital

Faccinetto,

Santos,

Taguchi

et al. 2024

PLoS ONE

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Background This study evaluated the long-term effects of percutaneous intervention in children and adolescents with transplant renal artery stenosis (TRAS). Methods Twenty patients had significant stenosis (>50%) and underwent percutaneous transluminal angioplasty (PTA/stenting) (TRAS group-intervention); 14 TNS (non-significant group -control) patients did not have significant stenosis (≤50%) and were treated clinically. The combined primary endpoints were death from all causes and late graft failure. The secondary endpoints were serum creatinine (SCr), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Results No statistically significant difference was found between TRAS—Intervention(N = 20) and TNS groups—Control (N = 14) for these clinical parameters: deaths, 1 (5.0%) vs. 0 (0.0%) (p = 1.000) and graft loss, 4 (20.0%) vs. 2 (14.3%) (p = 1.000). For the secondary endpoints, after 1 month and 1 year the values of SCr, SBP, and DBP were similar between the two groups but not statistically significant. Discussion In the TRAS group (intervention), the stent implantation was beneficial for treating refractory hypertension and reducing blood pressure (BP) in children and adolescents. Despite the outcomes being similar in the two groups, it can be inferred that the patients in the TRAS group (intervention) would have had a worse outcome without the percutaneous intervention. Conclusion TRAS treatment with stenting can be considered for children and adolescents. Because the sample in the present study comprised of only a specific population, further studies are needed for generalization. Trial registration The trial was registered at clinictrials.gov with trial registration number NCT04225338.

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Section: Discussionsupporting

confidence: 63%

Section: Plos Onementioning

confidence: 68%

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Retrospective analysis of percutaneous intervention of the renal artery in transplanted kidneys in children and adolescents at a tertiary public hospital

Faccinetto,

Santos,

Taguchi

et al. 2024

PLoS ONE

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“…Over time, recipients may suffer ischemic nephropathy due to TRAS caused by various reasons, thus leading to irreversible renal parenchymal damage [ 2 , 13 , 14 ]. Prolonged graft kidney ischemia may cause irreversible ischemic changes; as a result, graft function cannot recover fully even after restoring effective blood flow [ 15 ]. As previously reported, an increased resistance index, as determined by Color Doppler ultrasound, may reflect that a renal graft may have developed structural changes and cannot fully recover after revascularization [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Graft survival after percutaneous transluminal renal stenting for transplant renal artery stenosis (TRAS) is worse compared to matched cadaveric grafts without TRAS

Zhang,

Zou,

Zhou

et al. 2024

Renal Failure

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Objectives Transplant renal artery stenosis (TRAS) is now recognized as a curable disease with a good prognosis if intervention occurs in the early stage. However, the mid-term outcomes of TRAS when treated by percutaneous transluminal angioplasty with stent placement have yet to be fully elucidated. The purpose of this study was to compare mid-term graft and patient survival of TRAS group with a control group. Patients and methods Ninety-two patients were diagnosed of TRAS between January 2016 and January 2022 in our center. Fifty-six pairs of recipients with grafts from the same donor were selected as a study group with TRAS and a control group without TRAS, respectively. All donor kidneys were from deceased organ donation rather than living donors. The primary endpoints were graft and patient survival. The secondary outcomes were changes in renal graft function. Results The mean follow-up time for the TRAS group was 43.6 months, while the mean follow-up time for the control group was 45.3 months. In the TRAS group, the age of patients ranged from 11 to 62 years with 39 males and 17 females. In the control group, the age of patients ranged from 18 to 67 years with 40 males and 16 females. In the TRAS group, there were more patients with diabetic nephropathy as the primary renal disease compared to the control group (5/56 vs 0/56), and the incidence of acute rejection was higher in the TRAS group than in the control group (12/56 vs 3/56). Eight patients in the TRAS group and one patient in the control group experienced graft loss ( p = .019). Four patients in the TRAS group and four patients in the control group died with functional renal allograft during the follow-up time ( p = .989). The levels of eGFR did not differ significantly between the two groups in the first three years after kidney transplant ( p > .05). Patients in the TRAS group had worse graft functionality (eGFR, 44.96 ± 18.9 vs 54.9 ± 19.6 mL/min) in the fourth year when compared with the control group ( p = .01). Conclusions The graft function deteriorated faster, and graft survival was lower in the TRAS group treated by stent placement when compared with a control group without TRAS over the mid-term.

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Exploring the nexus: The place of kidney diseases within the cardiovascular-kidney-metabolic syndrome spectrum

Kanbay,

Guldan,

Ozbek

et al. 2024

European Journal of Internal Medicine

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Risk factors of transplant renal artery stenosis in kidney transplant recipients

Cited by 6 publications

References 17 publications

Retrospective analysis of percutaneous intervention of the renal artery in transplanted kidneys in children and adolescents at a tertiary public hospital

Retrospective analysis of percutaneous intervention of the renal artery in transplanted kidneys in children and adolescents at a tertiary public hospital

Graft survival after percutaneous transluminal renal stenting for transplant renal artery stenosis (TRAS) is worse compared to matched cadaveric grafts without TRAS

Exploring the nexus: The place of kidney diseases within the cardiovascular-kidney-metabolic syndrome spectrum

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