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case_images: (A-F) Histopathological findings. The histopathological evaluation of a renal biopsy sample. Subtle changes were observed in the glomeruli, with focal segmental mesangial expansion accompanied by the mild proliferation of mesangial cells (A-D), as well as focal chronic tubulointerstitial lesions, such as tubular atrophy and interstitial fibrosis, affecting up to 15% of the parenchyma (A). The arterioles predominantly exhibited normal morphology (A,D), while the arteries showed fibrointimal hyperplasia, which was more prominent in larger-caliber blood vessels (E,F).
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case_images: All glomeruli had nearly normal histopathological (HP) findings, except a rare mesangium expansion and the proliferation of a few mesangial cells and capsular adhesion in one glomerulus (Figure 1A-D). The tubulointerstitium was minimally changed, with distinct interstitial fibrosis and 15% tubular atrophy (Figure 1A). Myeloelastofibrosis causes thicker blood arteries (Figure 1E,F) without affecting arterioles (Figure 1A,D).
case_images: (A-D) Computed tomography angiography of the abdomen. Axial section, arterial phase, and narrowed lumen at the level of origin of renal arteries (A). Native shot, coronal section, and highly calcified aorta (B). Coronal section, porto-venous phase, and both kidneys post-contrast-opacified (C). Volume rendering (VR) view of a very pronounced calcified aorta (D). (Black arrows).
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case_images: Computed tomography angiography (CTA) of the abdomen revealed significant coarse calcifications in the abdominal aorta wall and its branches (Figure 2B), narrowing the lumen to 2 mm at the ostium of both renal arteries (Figure 2A).
case_images: (A-D) Percutaneous transluminal angioplasty. Native recording before percutaneous transluminal right renal angioplasty and after wire placement (A). The presentation of a balloon in the right renal artery (B). Marked location after balloon dilation (C). Marked stent location and the end final result (D). (Black arrows).
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case_images: An interventional radiologist from the second hospital performed PTA of the right renal artery and implanted a stent at the site of subocclusion (Figure 3), resulting in total renal function recovery.