Complicated Cases in GI

Anthony Kalloo, MD; Jonathan M. Buscaglia, MD

Chapter 46: Elevated Alkaline Phosphatase Level and Renal Cell Carcinoma (continued)

Karen Krok, MD

A 39-year-old African American man presented to the hospital for a nephrectomy after a recent diagnosis of renal cell carcinoma. Ten years prior, at the age of 29, the patient underwent a liver transplantation for cryptogenic cirrhosis. His only complication had been a recent elevation in his creatinine level. Three months before admission, he was found to have a creatinine of 4.0 mg/dL, up from a baseline of 1.4 mg/dL. His Prograf (Astellas Pharma, Deerfield, IL) (tacrolimus) was changed to Rapamune (Wyeth, Philadelphia, PA) (sirolimus). Two months prior to admission, he had a renal…