{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:45:37Z","timestamp":1772066737269,"version":"3.50.1"},"reference-count":23,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T00:00:00Z","timestamp":1637020800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T00:00:00Z","timestamp":1637020800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nephron"],"published-print":{"date-parts":[[2022]]},"abstract":"<b><i>Background:<\/i><\/b> Hyperkalaemia with metabolic acidosis is common but under-reported following kidney transplantation. Calcineurin inhibitors, such as tacrolimus, are widely used in the management of transplant patients and are associated with the development of hyperkalaemia. We report on 10 renal transplant patients, treated with fludrocortisone, following identification of hyperkalaemic metabolic acidosis. <b><i>Results:<\/i><\/b> All 10 patients were male aged (mean \u00b1 SD) 53.0 \u00b1 13.2 years; 7 were Caucasian and 3 South Asian. Before and after fludrocortisone administration, respective (mean \u00b1 SD) serum potassium was 6.1 \u00b1 0.4 mmol\/L and 5.3 \u00b1 0.3 mmol\/L (<i>p<\/i> = 0.0002); serum bicarbonate 18.5 \u00b1 1.6 mmol\/L and 20.5 \u00b1 2.3 mmol\/L (<i>p<\/i> = 0.002); serum sodium 135 \u00b1 4.6 mmol\/L and 137 \u00b1 2.2 mmol\/L (<i>p<\/i> = 0.0728); serum creatinine 181 \u00b1 61 \u03bcmol\/L and 168 \u00b1 64 \u03bcmol\/L (<i>p<\/i> = 0.1318); eGFR 42 \u00b1 18 mL\/min and 46 \u00b1 18 mL\/min (<i>p<\/i> = 0.0303); blood tacrolimus 10.1 \u00b1 2.9 ng\/mL and 10.4 \u00b1 1.4 ng\/mL (<i>p<\/i> = 0.7975); and blood pressure 129 \u00b1 15\/79 \u00b1 25 mm Hg and 126 \u00b1 24\/75 \u00b1 7 mm Hg. Pre-fludrocortisone, there were 7 episodes of serum potassium \u22656.5 mEq\/L, with 4 patients requiring admission for the treatment of hyperkalaemia. Following fludrocortisone, no patients had hyperkalaemia requiring inpatient management. <b><i>Conclusions:<\/i><\/b> Treatment of hyperkalaemic metabolic acidosis in transplant patients on tacrolimus with low-dose fludrocortisone resulted in rapid correction of hyperkalaemia and acidosis without significant effects on blood pressure or serum sodium. Fludrocortisone can be an effective short-term option for the treatment of hyperkalaemic metabolic acidosis in kidney transplant recipients on tacrolimus; however, patient selection remains important in order to reduce to risk of potential adverse effects. <\/jats:p>","DOI":"10.1159\/000519670","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T09:54:33Z","timestamp":1644314073000},"page":"190-196","source":"Crossref","is-referenced-by-count":8,"title":["Fludrocortisone Is an Effective Treatment for Hyperkalaemic Metabolic Acidosis in Kidney Transplant Recipients on Tacrolimus: A Case Series"],"prefix":"10.1159","volume":"146","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0292-7582","authenticated-orcid":false,"given":"Rouvick M.","family":"Gama","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Makanjuola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Wahba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Quan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mysore","family":"Phanish","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2021,11,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(67)90026-5"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl211"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl714"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000287430.19960.0e"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.2019.1592360"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-79-3-352"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(81)90534-9"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026465"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1997.85"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.4103\/1319-2442.124539"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2006.08.110"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.bj.2015.08.008"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.4103\/ijn.IJN_93_18"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.12485"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2011.07.006"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1159\/000351648"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1038\/nm.2497"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2008020166"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1D573"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2006.08.110"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2019.09.009"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002829"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000001037"}],"container-title":["Nephron"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/519670","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/519670","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:27:26Z","timestamp":1745422046000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000519670"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,16]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,3,4]]},"published-print":{"date-parts":[[2022,3,8]]}},"URL":"https:\/\/doi.org\/10.1159\/000519670","archive":["Portico"],"relation":{},"ISSN":["1660-8151","2235-3186"],"issn-type":[{"value":"1660-8151","type":"print"},{"value":"2235-3186","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,16]]}}}