Acute and Chronic Allograft Dysfunction in Kidney Transplant Recipients

Med Clin North Am. 2016 May;100(3):487-503. doi: 10.1016/j.mcna.2016.01.002. Epub 2016 Mar 21.

Abstract

Allograft dysfunction after a kidney transplant is often clinically asymptomatic and is usually detected as an increase in serum creatinine level with corresponding decrease in glomerular filtration rate. The diagnostic evaluation may include blood tests, urinalysis, transplant ultrasonography, radionuclide imaging, and allograft biopsy. Whether it occurs early or later after transplant, allograft dysfunction requires prompt evaluation to determine its cause and subsequent management. Acute rejection, medication toxicity from calcineurin inhibitors, and BK virus nephropathy can occur early or later. Other later causes include transplant glomerulopathy, recurrent glomerulonephritis, and renal artery stenosis.

Keywords: Allograft failure; Allograft rejection; Diagnostic evaluation; Kidney transplant.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / diagnosis*
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / therapy*
  • Follow-Up Studies
  • Graft Rejection / diagnosis*
  • Graft Rejection / etiology
  • Graft Rejection / therapy*
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic / diagnosis*
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / therapy*
  • Kidney Transplantation*
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy*
  • Risk Factors