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Transient hypoaldosteronism after renal allotransplantation
Israel Journal of Medical Sciences
|January 1, 1979
Summary
Post-renal transplant hyperkalemia in two patients was linked to a temporary failure of the transplanted kidney's renin-angiotensin system, resolving spontaneously within six weeks.
Area of Science:
- Nephrology
- Endocrinology
- Transplantation Immunology
Background:
- Investigating electrolyte imbalances, specifically hyperkalemia and hypokaliuria, post-renal allotransplantation.
- Assessing graft function and urinary output in patients experiencing these abnormalities.
Observation:
- Two patients presented with hyperkalemia and hypokaliuria despite adequate graft function and urinary output.
- Low plasma renin activity and aldosterone levels were observed in the upright position in the first patient.
- The second patient exhibited similar hormonal findings, with aldosterone secretion unresponsive to angiotensin II infusion during hyperkalemia.
Findings:
- Administration of 9 alpha-fluorohydrocortisone induced kaliuresis and decreased serum potassium in both patients.
- Biochemical and hormonal abnormalities spontaneously corrected within six weeks post-transplantation.
- Angiotensin II infusion response normalized after the correction period.
Implications:
- Suggests transient failure of the transplanted kidney's renin-angiotensin system as the primary cause of hyperkalemia.
- Highlights the dynamic nature of hormonal regulation following renal transplantation.
- Underscores the importance of monitoring and understanding post-transplant electrolyte disturbances.