Renal artery stenosis with erythrocytosis after renal transplantation

Abstract

Four patients (3 men, 1 woman) who had cadaver renal transplants and in whom renal artery stenosis and hypertension developed are reported. Erythropoietin-dependent erythrocytosis developed in association with these changes in the 3 men. All patients had stable renal function; the hypertension was well controlled. Absolute erythrocytosis thought to be secondary to local renal hypoxia due to decreased renal blood flow developed in 2 of the men. Erythrocytosis developed in the other man but his RBC [red blood cell] mass was at the upper limit of normal. In these patients, the erythropoietin-dependent erythrocytosis is probably secondary to intrarenal hypoxia due to renal artery stenosis. Erythrocytosis or elevated erythropoietin levels failed to develop in the woman despite severe renal artery stenosis. Possible reasons for this discrepancy are discussed.