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Renal and adrenal mechanisms in cyclosporine‐induced hyperkalaemia after renal transplantation
Author(s) -
LAINE J.,
HOLMBERG C.
Publication year - 1995
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1995.tb01984.x
Subject(s) - medicine , transplantation , urology , kidney transplantation , endocrinology
Abstract. CsA associated hyperkalaemia was investigated in 24 renal transplant recipients 6 months after transplantation. 51 Cr‐EDTA‐, PAH‐, lithium and sodium clearances, 24 h urinary creatinine and potassium excretions, plasma renin activity and aldosterone concentrations were measured. Transtubular potassium concentration gradient (TTKG) was calculated. An ACTH test was performed to document adrenal function. Eleven patients had hyperkalaemia. The TTKGs were low normal or reduced in both normo‐and hyperkalaemic patients implying inhibition of K + secretion. The hyperkalaemic patients received more CsA (mean dose 21.3 vs. 9–7 mgkg ‐1 d ‐1 , P = 0.01), and had lower lithium clearances (mean 9.9 vs. 170 mLmin ‐1 1.73m ‐2 , P <005). Adrenal function had no clear effect. Serum potassium concentration correlated with CsA dose (r=0.773, P<0.001) and inversely with lithium clearance (r = ‐0.568, P<0.01) suggesting that CsA induced decrease in distal tubular flow rate reduced K + excretion. Hyperkalaemia was not fully explained by renal mechanisms.