Which finding is most concerning for potential acute rejection requiring urgent evaluation?

Which finding is most concerning for potential acute rejection requiring urgent evaluation?

• A. Temperature 100.6 F.
• B. Hemoglobin 9.6 g/dL.
• C. Oliguria.
• D. Blood pressure 178/96 mmHg.

Answer: (C)

A drop in urine output in a renal transplant recipient signals graft dysfunction and is the most urgent clue for potential acute rejection. When the transplanted kidney is undergoing acute rejection, immune-mediated injury to the graft impairs filtration, causing the GFR to fall and urine production to plummet. Because this can progress rapidly to loss of graft function, it demands urgent evaluation to confirm the cause and start treatment promptly. This needs quick monitoring of kidney function (creatinine, BUN) and urine output trends, plus imaging to assess graft perfusion (often Doppler ultrasound) and, if indicated, a biopsy to confirm rejection and tailor therapy. While fever, anemia, or high blood pressure can accompany kidney issues, they are less specific indicators of acute rejection and don’t carry the same immediate risk signal as oliguria.

A drop in urine output in a renal transplant recipient signals graft dysfunction and is the most urgent clue for potential acute rejection. When the transplanted kidney is undergoing acute rejection, immune-mediated injury to the graft impairs filtration, causing the GFR to fall and urine production to plummet. Because this can progress rapidly to loss of graft function, it demands urgent evaluation to confirm the cause and start treatment promptly.

This needs quick monitoring of kidney function (creatinine, BUN) and urine output trends, plus imaging to assess graft perfusion (often Doppler ultrasound) and, if indicated, a biopsy to confirm rejection and tailor therapy. While fever, anemia, or high blood pressure can accompany kidney issues, they are less specific indicators of acute rejection and don’t carry the same immediate risk signal as oliguria.