Post-transplant urinary output from a living donor kidney can be large and dilute; what action is appropriate?

• A. It may be large and dilute and should be closely monitored.
• B. It will be zero for the first 24 hours.
• C. It will not be monitored after surgery.
• D. It will always be concentrated.

Answer: (A)

After a living-donor kidney transplant, a burst of urine output can occur because the new kidney immediately starts filtering, and its ability to concentrate urine often isn’t fully ready yet. This results in a large volume of urine that is dilute (low osmolality). Because this diuresis can lead to rapid fluid losses, the key nursing action is to monitor urinary output closely and track fluid status. Maintain adequate IV fluids to ensure renal perfusion and prevent hypovolemia, while also watching electrolytes and weight to catch any imbalances early. This approach supports graft function and helps prevent dehydration or electrolyte problems during the early recovery period.