Lecture Code : PG05-S1
Session Name : PG Education 5 - Kidney Transplantation
Session Topic : PG Education 5 - Kidney Transplantation
Date & Time, Place : June 11 (Thu) / 13:00-14:30 / Room 3 (GBR 103), 1F
Rapid Assessment and Management of Acute Kidney Injury in the Transplant Patient
Ho Sik Shin
Kosin University Gospel Hospital, Republic of Korea
Acute kidney injury (AKI) remains a frequent and prognostically significant complication in transplant recipients, driven by multifactorial insults including ischemia–reperfusion injury, calcineurin inhibitor toxicity, sepsis, and hemodynamic instability. Recent evidence highlights the importance of early recognition using dynamic changes in serum creatinine, urine output, and emerging biomarkers to enable timely intervention and risk stratification.
Rapid assessment should prioritize identification of reversible causes through a structured approach integrating volume status evaluation, drug exposure review, and imaging when indicated. Contemporary guidelines emphasize avoiding nephrotoxins, optimizing hemodynamics, and individualizing immunosuppressive regimens to mitigate further renal injury.
Management strategies remain largely supportive but increasingly tailored. Early goal-directed fluid management, vasopressor optimization, and avoidance of ineffective therapies such as low-dose dopamine are key principles. Biomarker-guided care bundles and precision medicine approaches are emerging, aiming to identify subphenotypes of AKI and personalize therapy.
In transplant populations, AKI is associated with increased risk of graft dysfunction and mortality, necessitating prompt escalation of care, including timely initiation of renal replacement therapy when indicated. Recent studies underscore the need for multidisciplinary coordination and post-AKI follow-up to reduce progression to chronic kidney disease and improve long-term outcomes.
In conclusion, rapid, structured assessment combined with early targeted management is critical in transplant-associated AKI. Integration of novel biomarkers and precision-based strategies represents a promising direction for improving patient and graft outcomes.
Keywords: Acute Kidney Injury, Kidney transplantation