Moffitt M&M Pearl 8/5/2015: post-kidney transplant AKI

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 Increasing.

  • Structural (immediate post-transplant period)
    • Vascular: renal artery stenosis, venous thrombus, anastamosis issue
    • Obstructive: urinoma, hematoma, lymphocele
    • Ureteral stricture can present later (distal ureter can gradually become ischemic and stricture)
  • Calcineurin inhibitor toxicity
  • Rejection
    • Antibody mediated
    • Cell mediated
  • Recurrence of primary disease (e.g. FSGS)
  • Infection (remember that infections such as pyelo in a normal patient don’t cause AKI, but it can in a post-transplant patient with a single functional kidney)
    • regular infections
    • opportunistic infections in immunocompromised host

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