Table 1.
Relevant laboratory parameters with clinical correlation over time
| Time in relation to the first kidney biopsy procedure | 1 year prior | 5 months prior | 2 months prior | 1 month prior | Time of first kidney biopsy procedure | Time of second kidney biopsy (1 month after the 1st biopsy) | 3 months after the 1st biopsy |
|---|---|---|---|---|---|---|---|
| Clinical situation/findings | Initial presentation to nephrology | Vomiting | Diarrhea | Elevated Cre even with resolution of diarrhea; tacrolimus held | Elevated Cre even after tacrolimus held | Cre progressively increasing; after the second biopsy’s resulting IVIG added and tacrolimus resumed | BK virus not detected in the serum |
| Serum Cre, mg/dl | 1.2 | 1.7 | 2.4 | 3.3 | 3.9 | 6.61 | 5.3 |
| Proteinuria | — | — | Negative | — | Trace | — | Trace |
| UA | — | — | 0 RBCs/hpf, 13 WBCs/hpf | — | 1 RBC/hpf, 19 WBCs/hpf | — | 1 RBC/hpf, 6 WBCs/hpf |
| Tacrolimus, ng/ml | 2.1 | 2.5 | 2.1 | 2.1 | <0.2 | <0.2 | <0.2 |
ATI, acute tubular injury; Cre, creatinine; hpf, high-powered field; IVIG, intravenous immunoglobulin; UA, urinalysis; RBC, red blood cell; WBC, white blood cell.