30 year old RENAL TRANSPLANT RECIPIENT with deranged RFT
Chief complaints
Renal transplant recipient came with deranged RFT values on routine investigation done for his renal transplant came to kamineni on 7/2/22
No c/o pedal odema
No c/o SOB ,facial puffiness
HOPI
Patient was apparently asymptomatic then on routine investigation done for renal transplantation revealed elevated creat levels
Sr creat - 3.5mg/dl
Urea - 85 mg/dl
No h/o decreased urine output ,urinary retention
Past history
H/o previous admissions for dialysis for 2 years (CRF)
K/c/o HTN on tab amlong 10 mg - 5 mg - 10 mg
Tab.arkamime 0.2 mg po/tid
H/o 2 times intubation and extubation i/v/o pulmonary oedema , hypertensive emergency and resistant hypertension 2 years back
H/o loculated pleural effusion and icd drainage 2 years back
Treatment history
K/c/o htn on tab amlong and arkamine
Surgical history
K/c/o renal transplant recipient
Personal history
Single
Appetite - normal
Bowel and bladder movement - normal
No known addictions
Family history - not significant
General examination
No pallor, icterus, cyanosis,lymphadenopathy, dehydration
Bp- 130 / 80 mm hg
PR - 88 BPM
RR- 16 cpm
Temperature - afebrile
Spo2 - 98 %at room air
Systemic examination
Cvs - s1,S2 heard ,no murmur
CNS - NAD
R/S - BAE + ,trachea central
PROVISIONAL DIAGNOSIS
K/C/O CRF with post live renal transplant
Presented with ? Acute renal failure
Secondary to tacrolimus toxicity or secondary to chronic infection
Treatment given
Tab amlong po/tid 10mg x5mg x10mg
Tab arkamine 0.2 mg /Tid
Tab tacrolimus 3mg-x-2 mg
Tab mycofenolate 750 mg / Tid
Tab enalapril 2.5mg po/od 9 am
Cap b complex po/od
Tab pan 40 mg /po/sos
BP,GRBS monitor TID ,I/O MONITORING
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Thanks Tasha Moore for your inputs but as this is chronic rejection may be due to low drug levels how herbal medicine deals with it.. are there any herbal medications which suppress immunity..?? Any studies or reports..??
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