Acute Tubular Necrosis in a Renal Transplant Recipient: Complication From Drip-Infusion Excretory Urography

HISTORICALLY, the chief technical problem in renal transplantation has been the reconstruction of the urinary tract. 1 For this reason, we have performed routine drip-infusion excretory urography in the early posttransplantation period, as soon as renal function became adequate to permit visualization of the collecting system and ureter. Thus, small leaks masked by catheter drainage might be detected and repaired prior to catheter removal and clinical manifestations. Furthermore, the differential diagnosis of subsequent oliguria would be simplified by knowing that the urinary tract was anatomically normal. These studies had been performed in more than 40 patients and were thought to be harmless until the experience cited in this brief article was encountered. Report of a Case A 24-year-old woman with a history of chronic glomerulonephritis since childhood had been undergoing hemodialysis for one year prior to receiving a kidney transplant from her 44-year-old father. An uncomplicated transplantation was performed in