Which symptom following a kidney transplant should prompt immediate evaluation for possible rejection?

• A. Increase in serum creatinine and decreased urine output.
• B. Mild fever.
• C. Slight blood pressure elevation.
• D. Normal hemoglobin.

Answer: (A)

The most urgent clue that a kidney transplant recipient may be experiencing rejection is a noticeable drop in graft function, shown by an increase in serum creatinine together with decreased urine output. When the transplanted kidney is attacked by the immune system, its ability to filter blood falls, so waste products like creatinine rise in the blood and urine production drops. This combination is a direct signal that the graft isn’t functioning properly and requires immediate evaluation to confirm whether rejection is occurring and to differentiate it from other causes of kidney dysfunction (such as dehydration, drug toxicity, or urinary obstruction). Quick assessment, including labs, imaging, and possibly a biopsy, helps guide urgent treatment to save the graft.

Mild fever can occur for many reasons and is not specific to rejection. Slightly elevated blood pressure can happen for various reasons and isn’t a definitive indicator of rejection. Normal hemoglobin also doesn’t indicate anything about the transplanted kidney’s status.