신이식후 발생한 고칼륨혈증

Abstract

Disorders of renal tubular function following renal transplantation are being recognized with increasing frequency. The incidence of hyperkalemia following renal transplantation has significantly increased in cyclosporine treated patients compared to those treated with azathioprine. The inpatient and outpatient records of 115 consecutive cyclosporine-treated patients, who underwent renal transplantation at Keimyung University Medical Center from December 1984 to December 1989, were reviewed for the development of hyperkalemia during the 3-month period immediately follow-

ing renal transplantation.

Unexplained hyperkalemia developed in 33 out of the 115 (28.7%) cycloporine-treated renal transplant recipients. The average onset of hyperkalemia was 15.4 days (range: 8—35), and the mean duration of hyperkalemia was 17.5 days. Hyperkalemia was mild-to-moderate in most case, but only 3 cases were severe (K > 6.5 mEq/L) enough to require emergency treatment.

The mean dosage of cyclosporine was 9.0 it 1.8 mg/kg, and whole blood (serum) cyclosporine levels were in the higher range 694±268ng/ml (268 + 70ng/ml). Hyperkalemia was frequently associated with hyperchloremic acidosis and normal anion gap, which is consistent with type IV renal tubular acidosis. Despite hyperkalemia, plasma aldosterone levels were in the lower normal range, and plasma renin activity levels were normal. Further studies are needed to establish the exact mechanism of hyperkalemia after renal transplantation. —Hyun Chul Kim, et al.: Hyperkalemia Following Renal Transplantation— Key Words: Hyperkalemia, Renal transplantation, Renal tubular acidosis