MRCP2-3948

MRCP2-3948

A 45-year-old man with diabetic renal disease underwent a cadaveric renal transplant. On the fourth day after surgery, his creatinine level was 140 µmol/L (60-110 µmol/L). He is currently taking high dose prednisolone, azathioprine, and ciclosporin for immunosuppression. His urine output was initially good at 60 ml per hour, but decreased to 40 ml per hour on the sixth day. Repeat blood tests showed that his creatinine level had increased to 210 µmol/L (60-110 µmol/L). He has no fever, with a pulse of 80 and a blood pressure of 150/80 mmHg. He appears to be euvolaemic and is not experiencing any abdominal pain.

What is the most appropriate next step in managing this patient?