Abstract
Two patients with advanced renal cell carcinoma underwent allogeneic hematopoietic stem cell transplantation and received cyclosporine (CSP) as part of their immunosuppressive therapy. Despite adequate renal function, both patients developed hyperkalemia. CSP was the only pharmaceutical agent to which this electrolyte abnormality could be attributed. Evaluation of renal tubule function suggested that CSP-associated isolated hyperkalemia resulted from tubular resistance to aldosterone. We propose that the presence of a single functional kidney may be a risk factor for isolated hyperkalemia due to CSP.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Chao NJ. Pharmacology and use of immunosuppressive agents after hematopoietic cell transplantation. In: Thomas ED, Blume KG, Forman SJ, ed. Hematopoietic Cell Transplantation. 2nd ed. Malden, UK: Blackwell Science; 1999:176–196.
Burdmann EA, Andoh TF, Yu A, Bennett WM. Cyclosporine nephrotoxicity. Semin Nephrol. 2003;23:465–476.
Aguilara S, Deray G, Desjobert H, Benhmide M, Le Hoang P, Jacobs C. Effects of cyclosporin on tubular acidification function in patients with idiopathic uveitis. Am J Nephrol. 1992;12:425–430.
Kamel KS, Ethier JH, Quaggin S, et al. Studies to determine the basis for hyperkalemia in recipients of a renal transplant who are treated with cyclosporine. J Am Soc Nephrol. 1991;2:1279–1284.
Fleming DR, Ouseph R, Herrington J. Hyperkalemia associated with cyclosporine (CsA) use in bone marrow transplantation. Bone Marrow Transplant. 1997;19:289–291.
Caliskan Y, Kalayoglu-Besisik S, Sargin D, Ecder T. Cyclosporine- associated hyperkalemia: report of four allogeneic blood stem-cell transplant cases. Transplantation. 2003;75:1069–1072.
Pei Y, Richardson R, Greenwood C, Wong PY, Baines A.. Extrarenal effect of cyclosporine A on potassium homeostasis in renal transplant recipients. Am J Kidney Dis. 1993;22:314–319.
Adu D, Michael J, Turney TM, McMaster P. Hyperkalemia in cyclosporine-treated renal allograft recipients. Lancet. 1983;2:370–372.
Kinugawa N, Okomoto Y, Ota S. Hyperkalemia in a cyclosporine A-treated allogeneic bone marrow transplant recipient [in Japanese]. Rinsho Ketsueki. 1992;33:53–57.
Childs RW, Clave E, Tisdate J, Plante M, Hensel N, Barrett J. Successful treatment of metastatic renal cell carcinoma with a nonmyeloablative allogeneic peripheral-blood progenitor-cell transplant: evidence for a graft-versus-tumor effect. J Clin Oncol. 1999;17:2044–2049.
Gardiner DS,Watson MA, Junor BJ, Briggs JD, More IA, Lindop GB. The effect of conversion from cyclosporine to azathioprine on renin-containing cells in renal allograft biopsies. Nephrol Dial Transplant. 1991;6:363–367.
Banttle J, Nath K, Sutherland D, Najarian JS, Ferris TF. Effects of cyclosporine on the renin-angiotensin-aldosterone system and potassium excretion in renal transplant recipients. Arch Intern Med. 1985;145:505–508..
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Takami, A., Asakura, H., Takamatsu, H. et al. Isolated Hyperkalemia Associated with Cyclosporine Administration in Allogeneic Stem Cell Transplantation for Renal Cell Carcinoma. Int J Hematol 81, 159–161 (2005). https://doi.org/10.1532/IJH97.04113
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1532/IJH97.04113