Delayed Graft Function and Tacrolimus Overdosage: A Case Report

Delay graft function (DGF) is a condition that is frequently associated with kidney transplantation and could complicate subsequent evolution of the renal graft. There are multiple factors implicated in the development of DGF, some avoidable through careful management, others without the possibility of correction. Gordon syndrome or type II pseudo-hypoaldosteronism and nephrotoxicity induced by calcineurin inhibitors are complications that can precipitate the development of DGF. These unfavorable manifestations can occur after high levels of Tacrolimus secondary starting calcineurin inhibitors treatment and can be prevented with careful monitorization of its levels. We reported a case of a 58-year-old patient who was admitted as receptor for cadaveric kidney transplantation (KT) and developed all the complications associated with Gordon-like syndrome and nephrotoxicity including DGF in the context of high Tacrolimus levels after starting calcineurin inhibitors treatment.