A 48 year old women who had renal transplant 5 months earlier comes to physician for follow up. She is intermitently compliant with her medicatiosn but has no symptoms. Vitals are normal but lav value shows creatinien of 2.1 up form 1.4 two weeks ago. Renal biopsy shows glomerulitis with polymorphonuclear cells, fibrin thrombi in the glomerular capillaires and vasculitis. C4d staining is positive. 1. What condition is likely developing in this lady? 2. What medicaiton specifically targets the immune cells directly responsible for this patients condition? 3. How does it work?

How do you remember renal physiology?
Use the mnemonic, A WET BED: A) maintenance of ACID-base balance; W) maintenance of WATER balance; E) balance of ELECTROLYTES; T) removal of TOXINS; B) control of BLOOD pressure; E) production of ERYTHROPOIETIN; and D) metabolism of vitamin D.