Case 12: Diagnostic Testing

Case 12 Index

Take a look at some initial tests below.
Urinalysis/microscopy
Basic labs
Kidney Ultrasound
The radiologist tells you that though the kidney transplant appears normal, there is thickening of the urothelium.
Urine sediment

Basic Lab Ref

Your patient receives 2 liters of isotonic fluid, and the creatinine has now risen to 2.5 mg/dL.  Your team decides to perform a biopsy of the transplant kidney.

Before we take a look at the biopsy, what’s moved to the top of your differential diagnosis? Choose 3 before moving on!
Pre-renal acute kidney injury
Obstructive nephropathy
Acute interstitial nephritis (AIN)
Adenovirus nephropathy
BK nephropathy
Acute cellular rejection
Antibody mediated rejection
Bladder cancer
Renal cell carcinoma
Urinary tract infection
IgA nephropathy
Membranous nephropathy

Before the biopsy, your urology colleagues perform a cystoscopy and tell you that there is no evidence of any masses.

Click here to move on!

Case 12 Index
Case 12 Introduction
Case 12 Physical Exam