Time course of clinical and laboratory markers in relation to date of TMA diagnosis. The date of TMA diagnosis is marked as day 0 (black vertical line) and represents the posttransplant day when study diagnostic criteria for TMA were fulfilled, including elevated LDH and schistocytosis. We additionally included the timing of proteinuria (≥30 mg/dL on random urinalysis), hypertension (defined as a systolic blood pressure >95th percentile for age, sex, and height), AKI (doubling of the pretransplant serum creatinine), and a haptoglobin less than the lower limit of normal. For each variable, the white vertical lines represent the median day the criterion became positive and the gray area the IQR. Hypertension (day −14) and an elevated LDH (day −13) were the first markers of TMA, followed by proteinuria (day −10). Schistocytosis occurred on day 0, because this was typically the last criterion to turn positive and thus defined the TMA diagnosis date. A decreased haptoglobin lagged the first elevation in LDH by almost 2 weeks. AKI, defined using serum creatinine, occurred a median of almost 28 days after TMA was diagnosed.