75 years old, Male, Reason: ESRD s/p cadaveric transplant in 2003, now with AKI/ATN likely due to contrast nephropathy. assess graft function, obstruction History: AKI Transplanted kidney: No perinephric fluid collections are identified. The transplant kidney measures 11.8 cm in length. No shadowing calculus or suspicious lesions are evident. No evidence of hydronephrosis or hydroureter.Vascular Doppler data: The peak systolic velocity of the iliac artery is 1.0 m/sec. The peak systolic velocity at the anastomosis is 3.5 m/sec with a resistive index of 0.87 appearing similar to prior exam.Peak systolic velocity of the renal artery is 3.5 m/sec at the origin, 1.9 m/sec in the midportion, 1.3 m/sec distally with system indices of 0.88, 0.84, 0 .81 respectively. These peak systolic velocities and resistive indices are similar to prior exam.Resistive indices within parenchymal branches very between 0.7 and 0.8 which are minimally increased compared to the prior exam.Other: Mild to moderate amount of ascites is present.
1.Increase velocity at the renal artery anastomosis is stable since the prior exam, but significant stenosis at this site cannot be excluded.2.Increased resistive indices in the main renal artery and in the parenchymal arterial branches.3.Mild to moderate ascites is present.