Renal transplant

Prep for USMLE Forum

» Log in | Register

Forum

Step 1

Match

Prep4USMLE Forum » USMLE Step 2 CK Forum » Internal Medicine Forum

Renal transplant

Author

6 Posts

s2006
Forum Senior

Topics: 17
Posts: 39

11/16/06 - 08:40 PM

A 42 yr old female is hospitalized following renal transplant for chronic renal failure and now has increased BUN and CR levels. Prior to this she was on hemodialysis for 3 yrs. Current meds are cyclosporine and prednisone. Over the past 48 hours urine output has remained stable. Examination shows no abnormalilties. Both renal biopsy and scan conform the diagnosis of acute rejection. Which is most effective treatment?

rody
Forum Senior

Topics: 46
Posts: 124

11/17/06 - 08:43 AM

WHAT???ANY CHOICES

s2006
Forum Senior

Topics: 17
Posts: 39

11/17/06 - 10:34 AM

DIURESIS&ALKALINISATION OF URINE or RENAL DIALYSISor INCREASE DOSE OF CORTICOSTEROIDS orIMMEDIATE DISCONTINUATION OF CYCLOSPORINE or TRANSPLANT NEPHRECTOMY

sunny2
Forum Elite

Topics: 51
Posts: 385

11/17/06 - 11:04 AM

Increase dose of Methylprednisolone

AAAAA
Forum Fanatic

Topics: 156
Posts: 1,991

11/17/06 - 05:08 PM

BUN and creatinine elevations above baseline may be a sign of rejection in renal transplant patients and of deterioration in renal function in patients with predialysis CRF.

Sometimes the only choice is removal of the transplanted kidney if medical therapy failed

___________________
seeking study partner in USMLE, Canadian MCC OSCE examination

mammyQ
Forum Newbie

Topics: 5
Posts: 24

11/28/06 - 02:09 PM

Accelerated acute rejection is a very early, rapidly progressive, aggressive rejection reaction. It can occur within the first week of transplantation. Immediate therapy with anti–T-cell antibodies and pulse corticosteroids may reverse the process. Approximately 50% of cases can be salvaged.

I agree with sunny2. A trial with a corticosteroid is imp.

You don't have permission to post.