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September 1980

Renal Artery Stenosis With Erythrocytosis After Renal Transplantation

Author Affiliations

From the Departments of Medicine (Drs Bacon and Ricanati) and Radiology (Dr Rashad), Case Western Reserve University School of Medicine, Cleveland Metropolitan General Hospital, and the Department of Laboratory Hematology and Blood Banking, Cleveland Clinic Foundation (Dr Rothman).

Arch Intern Med. 1980;140(9):1206-1211. doi:10.1001/archinte.1980.00330200082025

• We present here results of studies on four patients (three men, one woman) who had had cadaver renal transplants and in whom renal artery stenosis and hypertension developed. Erythropoietin-dependent erythrocytosis developed in association with these changes in the three men. All patients had stable renal function and the hypertension was well controlled. Absolute erythrocytosis thought to be secondary to local renal hypoxia due to decreased renal blood flow developed in two of the men. Erythrocytosis developed in the other man but his RBC mass was at the upper limit of normal. In these patients, we suspect that the erythropoietin-dependent erythrocytosis is 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.

(Arch Intern Med 140:1206-1211, 1980)