Objective: To demonstrate the potential reversibility of ischaemic kidney failure caused by total or subtotal renal artery (RA) occlusion after delayed PTA/stenting in six patients. Material, methods and results: Case 1: F, age 34 years. Total acute occlusion of both RA, one polar artery patent. Dialysed for two weeks. Bilateral RAPTA/stenting restored kidney function. F/U three years: Cr level 120 mmol/l. Case 2: M, age 70 years. Occlusion of a solitary kidney RA. Dialysed for one week. PTA/stenting of the occluded artery restored kidney function. The patient died two weeks later of MI, kidney function normal. Case 3: M, age 49 years. CRI. Occlusion of a solitary kidney artery. Dialysed for 12 days. Recanalisation of the occluded RA by stent implantation restored kidney function. F/U 18 months: Cr 380 mmol/l. Case 4: F, age 72 years. Living related donor transplantation 29 years ago. Graft failure due to subtotal occlusion of RA. Dialysed for two weeks. PTA restored graft function. F/U: Good graft function for 12 months, then again graft failure. Case 5: M, age 47 years. Cadaverous transplantation two years ago. Graft failure due to subtotal occlusion of graft artery. Dialysed intermittently for 9 months. PTA restored kidney function. F/U 42 months: Dialysis free, graft function stable. Case 6: F, age 30 years. Second cadaverous transplantation. Two months after transplantation graft failure due to ostial RA stenosis. Dialysed for one week. PTA restored graft function. F/U: 11 months dialysis free, then again graft failure due to rejection. Conclusion: Authors experience confirms, that ischaemic kidney failure due to RA occlusion may be reversible even days to weeks after occlusion and that even delayed RA recanalisation should be attempted.

        Key words: ischaemic nephropathy – renal artery PTA – kidney transplantation – renal failure