A Renal Transplant Recipient with Elevated Blood Pressure and Loose Stool

Kidney transplantation complications may include acute, subacute, and chronic conditions which range across surgical complications, infectious complications, or medication side effects. Vital signs, including a weight, may be abnormal in patients with kidney transplant as these patients often are on immunosuppressant medications. Providers should include common pediatric community-acquired etiologies of symptoms as well as those unique to transplant patients in the differential diagnosis. Initial evaluation should include serum electrolytes, serum creatinine, and urinalysis. Imaging is often not needed on first-pass evaluation unless there is specific concern for urinary obstruction. Initial management should include aggressive fluid resuscitation with normal saline and avoidance of medications that may worsen acute kidney injuries such as NSAIDs and potassium-containing solutions.