Review Question - QID 100439

Chronic graft rejection of a transplanted kidney typically manifests with hypertension and elevated creatinine. Upon renal biopsy, fibrosis in the interstitium, glomerular and tubular atrophy, and arteriosclerosis are often seen.

It is believed that chronic graft rejection begins with an antibody-mediated immune response against the vasculature of the graft. Antibody binding to the vasculature leads to leukocytes being brought to the site and subsequent leukocyte-mediated damage. This eventually causes thickening of the vessel, and leukocytes move into the wall of the vessel. More damage and thickening can occur, thus causing graft ateriosclerosis. Ischemia can result, giving rise to glomerular and tubular atrophy. Contrarily, glomerular crescents form in Bowman's space in response to injury to glomerulus, and are associated with most forms of rapidly progressive glomerulonephritis (such as IgA nephropathy or lupus nephritis).

Incorrect Answers:
Answer 1-4: As discussed above, fibrosis in the interstitium, glomerular and tubular atrophy, and arteriosclerosis are often seen in biopsies of chronic graft rejection.