Outcomes of patients coming to the emergency department after kidney transplantation

Abstract

Introduction: In kidney transplantation (KT) practice, improvements in patient care led to increased graft and patient survival. This study aimed to determine the symptomatology of KT patients presenting to emergency department (ED), their final diagnoses, and outcomes.
 Material and Method: Data including demographic data (age and gender), chief complaints (CCs), number of ED presentations, ED presentation date, KT date, donor type (live/deceased), patient disposition (discharge/admission), final diagnosis, and outcomes (acute renal graft dysfunction/graft loss/death) were retrieved and analyzed. 
 Results: Twenty-five KT patients presented to ED during the study period. These patients presented to ED for 46 times with 50 CCs. Fever was the most frequent CC (20%). The ED presentation led to a final diagnosis of infection in 32 presentations (69.4%). The most frequent infection was urinary tract infection (UTI) (26.1%) followed, by acute gastroenteritis (17.4%) and upper respiratory tract infection (17.4%). Acute graft dysfunction was the most common “non-infectious diagnosis” (17.4%) followed by cardiovascular disease (8.5%). The ED presentation led to admission in 32.6% (15/46) of the cases. Among 15 admissions, 7 (46.7%) were due to UTI. No rejections, graft loss, or mortality occurred following any ED presentations.
 Conclusion: When evaluating KT patients in the ED, physcians should bear in mind that they could have an infectious pathology that is often associated by fever, also they should check for acute graft dysfunction and cardiac pathologies.