ESRD After Kidney Transplantation

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When a patient has ESRD and requires transplant, typically, the diseased kidneys are not removed. However, relevant diagnoses should be based on function of the transplanted kidney.

ESRD was treated with the kidney transplant, but the patient may have continued chronic kidney disease (CKD) following transplant. The process and criteria for diagnosing CKD, including ESRD, remains the same in the transplanted kidney as a native kidney, but would include “T” for transplant.

For example, an eGFR of 50mm/1.73m2 would be Stage 3 T CKD.  Keep in mind that systemic conditions, like polycystic kidney disease, may persist following the transplant and remain a reportable diagnosis.

In the transplanted patient, documentation includes:

  • S/P transplant
  • If there is any evidence of organ rejection
  • Current level of measured renal function:
    • Normal
    • Acute kidney injury (AKI)
    • Chronic kidney disease (CKD) stage 1T, 2T, 3T, 4T, or 5T
  • Systemic renal based conditions e.g., polycystic kidney disease

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