Finally, urine leak may present similarly to delayed renal function because it causes low urine output and, as a result of urine reabsorption, an elevation in serum creatinine and urea concentrations. Possible causes include ureteral infarction or failure of the ureterovesical anastomosis. Urine leaks can usually be diagnosed using ultrasonography or isotope renography. Stenting across the defect may be attempted, although surgical reconstruction may be necessary in some cases.

Early Post-transplant Period (1 Week to 6 Months). Many of the pathologies that cause DGF may also cause renal dysfunction in the early post-transplant period. Prerenal state, for example, may occur secondary to inadequate fluid intake, diarrhea, or use of drugs that impair tubuloglomerular feedback, such as ACE inhibitors or NSAIDs. In addition, renal vessel thromboses may not occur until several weeks post-transplantation.