Tag Archives: Renal Transplant

7/27 Morning Report w/ Ryan: AKI s/p renal transplant

A middle aged woman w/ renal transplant 2/2 IgA nephropathy presents with anemia, thrombocytopenia, and AKI, ultimately thought 2/2 rejection from medication non-compliance.
**Differential of AKI in post-transplant patient: think of all the usual causes of AKI in a non-transplanted patient PLUS the following additional list. Mnemonic from Dr. Allison Webber (UCSF transplant nephrology) of Serum CReatinine RIsing**
Structural (immediate post-transplant period)
-vascular: RAS, venous thrombus, anastamosis issue
-obstructive: hematoma, urinoma, lymphocele
-ureteral stricture can present later
Calcineurin inhibitor toxicity
Rejection
-Antibody mediated
-Cell mediated
Recurrence of primary disease (e.g. FSGS)
Infection (remember that infections in a normal patient may not cause AKI, but they do in a post-transplant patient with one kidney)
-regular UTIs
-opportunistic infections
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