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Abstract

Background:

Although systemic hypertension and renal insufficiency occur commonly after transplant, no investigation has clearly delineated the prevalence and associated risk factors for renal artery stenosis (RAS) in cardiac transplant recipients.

Methods: We performed surveillance coronary angiography and concomitant renal artery angiography in 66 consecutive cardiac transplant recipients. All patients were at least 1-year post transplantation. Renal artery stenosis was defined as greater than 50% stenosis with visual estimation and /or greater than 10 mmHg gradient across the stenosis. Associated cardiovascular risk factors such as diabetes, mean arterial blood pressure (MAP), serum creatinine and lipid profiles were also analyzed. The serum Cyclosporin and Tacrolimus levels were also obtained.

Results:

Seven patients met the criteria for renal artery stenosis in our cohort (11%). There was no significant difference in the presence of coronary allograft vasculopathy, mean arterial blood pressure, serum creatinine, serum triglyceride or presence of diabetes in the patients with renal artery stenosis compared to those without it. Furthermore, neither the severity of coronary allograft vasculopathy nor the severity of hypertension (2 or more antihypertensive agents) correlated with the presence of renal artery stenosis. There was a significant correlation of triglycerides and coronary allograft vasculopathy. Two of the patients with renal artery stenosis were referred for renal artery stenting with subsequent short-term improvement in the mean arterial pressure.

Inferences: Renal artery stenosis is an uncommon finding in cardiac transplant recipients and routine angiography cannot be justified. Furthermore, no clinical predictors for renal artery stenosis in this patient cohort were identified. (See Table)

Patients# patientsTriglycerides mg/dlCreatinine mg/dlMAP mmHgLDL mg/dl
With RAS72341.810798
Without RAS591741.611091
p valuensnsnsns
Patients# patientsTriglycerides mg/dlCreatinine mg/dlMAP mmHgLDL mg/dl
With RAS72341.810798
Without RAS591741.611091
p valuensnsnsns
Patients# patientsTriglycerides mg/dlCreatinine mg/dlMAP mmHgLDL mg/dl
With RAS72341.810798
Without RAS591741.611091
p valuensnsnsns
Patients# patientsTriglycerides mg/dlCreatinine mg/dlMAP mmHgLDL mg/dl
With RAS72341.810798
Without RAS591741.611091
p valuensnsnsns
Hypertension, Angiography, Heart transplant patients
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© American Journal of Hypertension, Ltd. 2001
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