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Rapid Progression of Native Renal Artery Fibromuscular Dysplasia Following Kidney Donation
Author(s) -
Parasuraman Ravi,
Attallah Nizar,
Venkat K.K.,
Yoshida Atsushi,
Abouljoud Marwan,
Khanal Sanjaya,
Greenbaum Adam
Publication year - 2004
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2004.00581.x
Subject(s) - fibromuscular dysplasia , medicine , renal artery , stenosis , angiography , kidney , renal artery stenosis , radiology , blood pressure , renovascular hypertension , dysplasia , cardiology , surgery
Fibromuscular dysplasia is the second commonest anatomical abnormality apart from multiple renal arteries in the potential live donors. Pretransplant evaluation of the donors may include an angiography to evaluate the renal arteries, and failure to recognize renal arterial stenosis, particularly fibromuscular dysplasia, by noninvasive methods may eventually lead to hypertension and ischemic renal failure. We report a case of fibromuscular dysplasia that was undetected by computed tomographic angiography prior to donation. One year after kidney donation, it rapidly progressed to severe symptomatic stenosis with hypertension and acute renal failure. Following renal artery angioplasty, her blood pressure normalized over a period of 2 weeks without any need for antihypertensive medications and the serum creatinine returned to her baseline. The acceptability of renal donors with fibromuscular dysplasia depends on the age, race and the availability of the other suitable donors. Mild fibromuscular dysplasia in a normotensive potential renal donor cannot be considered a benign condition. Such donors need regular follow‐up postdonation for timely detection and treatment.