Ultrasonic Diagnosis of Cytomegalovirus Induced Stenosis of the Transplantation Renal Artery

Transplant renal artery stenosis (TRAS) is a well-known vascular complication after kidney transplantation. Most often, this occurs in the first 6 months after kidney transplantation and is one of the main causes of graft loss and premature death of transplant recipients. Renal hypoperfusion, which occurs with TRAS, leads to activation of the renin-angiotensin-aldosterone system. Patients usually have worsening or refractory hypertension and often dysfunction of the allograft. Timely diagnosis and treatment of TRAS can prevent allograft damage and systemic consequences. We report a patient with stenosis of the renal artery graft associated with cytomegalovirus infection. Cytomegalovirus is involved in the pathogenesis of renal artery stenosis in a transplant. During the serological determination of examination, cytomegalovirus positive titers of IgG antibodies to cytomegalovirus and quantitative DNA in blood serum by polymerase chain reaction were revealed. Duplex sonography is the most frequently used screening method, while angiography provides the final diagnosis. The results of the Doppler study of the renal allograft were compatible with critical stenosis of the renal artery.