Acute Tubular Necrosis Following Renal Transplantation: A Case Report

Acute tubular necrosis (ATN) remains one of the most frequent causes of delayed graft function (DGF) following renal transplantation, particularly in the early postoperative period. It is commonly associated with ischemia-reperfusion injury, prolonged cold or warm ischemia time, donor-related hemodynamic instability, and the nephrotoxic effects of calcineurin inhibitors (CNI) such as cyclosporine. ATN contributes significantly to early post-transplant morbidity, impacts long-term graft survival, and poses diagnostic challenges due to its clinical overlap with acute rejection. Cyclosporine-induced nephrotoxicity can result in severe tubular injury, leading to ATN, particularly in the early post-transplant period. Despite its efficacy in preventing graft rejection, cyclosporine's toxic effects on the renal vasculature and tubular cells can exacerbate ischemia-reperfusion injury, prolong graft dysfunction, and increase the need for dialysis. Here, we report a case of ATN following renal transplantation in a patient who was on cyclosporine.