Unusual Cause of Postrenal Biopsy Anuria in a Renal Transplant Patient

• Published in: The American journal of the medical sciences 2011-03, Vol.341 (3), p.250-252
• Main Authors: Huang, Chien-Wei, MD, Chou, Kang-Ju, MD, Fang, Hua-Chang, MD, Chen, Chien-Liang, MD, Lee, Po-Tsang, MD, Chung, Hsiao-Min, MD, Hsu, Chih-Yang, MD
• Format: Article
• Language: English
• Subjects: Anuria - etiology; Arteriovenous fistula; Arteriovenous Fistula - complications; Arteriovenous Fistula - diagnosis; Arteriovenous Fistula - diagnostic imaging; Arteriovenous Fistula - therapy; Biological and medical sciences; Biomarkers - blood; Biopsy - adverse effects; Biopsy - methods; Creatinine - blood; Dyspnea - etiology; Embolization, Therapeutic; General aspects; Humans; Internal Medicine; Kidney Transplantation; Kidneys; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Renal allograft; Renal Artery Obstruction - complications; Renal Artery Obstruction - diagnosis; Renal Artery Obstruction - diagnostic imaging; Renal Artery Obstruction - therapy; Renal biopsy; Renal Circulation; Renovascular diseases; Ultrasonography, Doppler, Color; Urinary system involvement in other diseases. Miscellaneous
• ISSN: 0002-9629; 1538-2990
• DOI: 10.1097/MAJ.0b013e3182037477

Abstract Arteriovenous fistula (AVF) is an uncommon but well-known complication of percutaneous renal biopsy. Most postbiopsy AVFs are asymptomatic and regress spontaneously; however, some AVFs result in hypertension, hematuria and renal insufficiency. Transplant renal artery stenosis (TRAS) is a potentially curable cause of posttransplant arterial hypertension, allograft dysfunction and graft loss. Whether postbiopsy AVF superimposed on TRAS also regresses spontaneously is unknown. The authors present a case of acute renal failure in a 56-year-old male renal allograft recipient with the combination of postbiopsy AVF and TRAS. At first, the authors performed percutaneous angioplasty with stent implantation for the TRAS, but the AVF gradually enlarged. Eighteen months later, the patient began to experience hypertension, and his serum creatinine level increased; he received transcatheter arterial embolization therapy for enlarged AVF, and his renal function returned to baseline level. Transplant renal artery stenosis.