[Differential diagnosis of the rejection crisis and toxic and immune-induced nephropathy]

The work is based on the analysis of materials concerning 26 patients with transplanted allogeneic kidneys. All the patients received immunodepressive therapy with a combination of prednisolone and sandimmune. The posttransplantation period was complicated by sandimmune nephropathy in 11 and by a rejection crisis in 15 patients. The following tests were used in the differential diagnosis of these two complications: clinical (firmness of the allogeneic kidney determined by palpation, arterial hypertension, hyperthermia), laboratory (level of creatinine in blood and its clearance, potassium and sodium in urine), and instrumental-functional (ultrasonic examination, electrothermometry, rheography). With the use of these tests, nephrotoxicity of sandimmune origin and rejection crisis were differentiated successfully in all cases.