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