2015年8月20日星期四

Is High Creatinine after Kidney Transplant Caused by Delayed Graft Function (DGF)

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“I did a kidney transplant with a perfect kidney donator two months ago. Creatinine has been ranging from 1.6 to 1.9 recently. I have gained 15 pounds since the surgery. What are the chances that the muscular buildup causes the high creatinine? Or is it a Delayed graft function (GRF) condition issue that requires a further biopsy?”
The question related to high creatinine after kidney transplant confuses a lot of patients. Creatinine comes from muscle. The patient may have gained significant weight after the surgery, however, doctors may doubt if all of that is muscle. The major component is likely to be the fat.
There are two possible causes for the slightly elevated creatinine months after the transplantation. And I will introduce for you as follows:
1. Acute Tubular Necrosis(ATN)
Acute tubular necrosis is surgical complication that commonly occurs one week after kidney transplantation. Clinical incidence rate of ATN is approximately 30%. In some cases, patients may need dialysis treatment. Usually, ATN takes three-four weeks to recover. Thereby, if it is ATN that have caused high creatinine, patients may have already recovered by two months.
2. Delayed graft function (DGF)
Delayed graft function (DGF) is common after kidney transplantation. Patients will present anuria or oliguria. Creatinine may stay at constant high levels, or may drop down very slowly. DGF can increase risks of acute repulsion reactions and can shorten long-term survival rate of the patient. DGF delays kidney function recovery or cause permanent kidney injury.
In clinical treatment, there are several practicable methods to decrease risks of DGF, including: first, decreasing ischemia state during the transplantation; second, anti-inflammation treatment; third, application of antioxidants; fourth, using medicines to dilate blood vessels.
Now for the above-mentioned patient, it is more likely that the DGF is the inducing factor for the high creatinine. Doctors may cause to do biopsy to make sure the fundamental renal pathological changes. However, as far as kidney specialists are concerned, the biopsy-by drawing out a part of kidney tissues, is a traumatic test that may aggravate kidney damages. Thereby, we advise latest immune related tests for the patient. Meanwhile, nursing care plays a significant role for the patient to regain from the rejection problems and high creatinine levels.
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