Question About Renal Tranpslant. Help please.

  1. Hello. I am a home health nurse and need some information on estimated GFR after renal surgery. My patient, 62 years old, had a kidney transplant 10years ago. He recently had a toe amputated and has had a MI in the last 2 weeks. He underwent heart cath and was found to have 5 blockages in his heart. The doctors are delaying surgery d/t the pt. having MRSA from the toe amputation. The pt. came home with PICC line and is taking abx daily at home via IV to get rid of the infection. I drew blood work on him this last week. His creatinine was 1.2 and his BUN was 23. His estimated GFR was 65, which shows him in Stage 2 Kidney disease, showing kidney damage and mild decrease in GFR. For a healthy kidney, the GFR estimated is 90 or greater. My question is does having a kidney transplant effect the GFR estimated or is my pt. losing function in his transplanted kidneys? Any info, would be greatly appreciated. Thanks.
  2. Visit iamarn profile page

    About iamarn

    Joined: Mar '06; Posts: 9
    Registered Nurse

    4 Comments

  3. by   km5v6r
    Your pt has a decrease in renal function. It maybe temporary or permanent. Contrast and antibiotics may cause a bump in the BUN and Cr as well as dehydration. Ironically enough the antirejection meds given after transplant are also nephrotoxic. A GFR of 60 still 10 yrs post transplant is really very good. Dialysis is considered necessary when the Cr clearance is down around 12-15.
  4. by   iamarn
    I understand that my pt has a decrease in renal function. My question is what is the normal estimated GFR after renal transplant. Is it normal to have a reduced estimated GFR 10 years post-transplant? Thanks...
  5. by   iamarn
    Well, I did more bloodwork on my pt. today. His BUn is 23 and Creatinine. His estimated GFR has dropped from 65 last week to 59 this week. I think I am going to just call his nephrologist tomorrow.
  6. by   traumaRUs
    That's what I would do also. It may be that his transplanted kidney isn't working as well as it used to or it could be baseline function for this kidney. However, without a hx of the kidney, no one could say except for his nephrologist.

close