Mechanisms and management of drug-induced hyperkalemia in kidney transplant patients

Rizk, John; Lazo, Jose G.; Quan, David; Gabardi, Steven; Rizk, Youssef; Streja, Elani; Kövesdy, Csaba P.; Kalantar-Zadeh, Kamyar

doi:10.1007/s11154-021-09677-7

Cited by 6 publications

(3 citation statements)

References 115 publications

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“…As magnesium and phosphate wasting is often observed in the acute post-transplant period, an increased intake of dairy foods rich in phosphate and magnesium is recommended [83]. Additionally, hypo- and hyperkaliemia are often present and usually drug-related side effects as up to 40% of the patients treated with cyclosporine develop hyperkaliemia [84]. If hyperkaliemia occurs, dietary intake of potassium may be limited and other reversible causes of hyperkaliemia such as metabolic acidosis must be addressed [85].…”

Section: Acute Post-transplant Stage – Nutritional Solutions For Drug...mentioning

confidence: 99%

Fueling the success of transplantation through nutrition: recent insights into nutritional interventions, their interplay with gut microbiota and cellular mechanisms

Koehler,

Späth,

Meyer

et al. 2024

Current Opinion in Organ Transplantation

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Purpose of review The role of nutrition in organ health including solid organ transplantation is broadly accepted, but robust data on nutritional regimens remains scarce calling for further investigation of specific dietary approaches at the different stages of organ transplantation. This review gives an update on the latest insights into nutritional interventions highlighting the potential of specific dietary regimens prior to transplantation aiming for organ protection and the interplay between dietary intake and gut microbiota. Recent findings Nutrition holds the potential to optimize patients’ health prior to and after surgery, it may enhance patients’ ability to cope with the procedure-associated stress and it may accelerate their recovery from surgery. Nutrition helps to reduce morbidity and mortality in addition to preserve graft function. In the case of living organ donation, dietary preconditioning strategies promise novel approaches to limit ischemic organ damage during transplantation and to identify the underlying molecular mechanisms of diet-induced organ protection. Functioning gut microbiota are required to limit systemic inflammation and to generate protective metabolites such as short-chain fatty acids or hydrogen sulfide. Summary Nutritional intervention is a promising therapeutic concept including the pre- and rehabilitation stage in order to improve the recipients’ outcome after solid organ transplantation.

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Section: Acute Post-transplant Stage – Nutritional Solutions For Drug...mentioning

confidence: 99%

Fueling the success of transplantation through nutrition: recent insights into nutritional interventions, their interplay with gut microbiota and cellular mechanisms

Koehler,

Späth,

Meyer

et al. 2024

Current Opinion in Organ Transplantation

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show abstract

“…Due to low tubular reabsorption and disproportionately high parathormone levels, hypophosphatemia is common in the first few weeks following KTx [ 77 ]. In the early post-KTx period, it is necessary to monitor phosphorus blood levels on a weekly basis, especially in patients with rapidly improving graft function, as they may require high-phosphate products or even their oral supplementation [ 78 , 79 ]. In the early post-transplant period, there is a tendency towards either hypo- or hyperkaliemia.…”

Section: Dietary Recommendations In the Early Post-ktx Periodmentioning

confidence: 99%

“…In the early post-transplant period, there is a tendency towards either hypo- or hyperkaliemia. Hyperkalemia is usually a side-effect of medications; 5 to 40% of patients treated with CNIs develop hyperkalemia [ 79 ]; other medications include i. a. sulfamethoxazole with trimethoprim, β-blockers, and heparin. If hyperkalemia occurs (mainly in patients with impaired graft function), the potassium intake should be reduced to 3 g/day [ 80 ], once other reversible causes of hyperkalemia such as metabolic acidosis, which is common in the early post-KTx period, have been excluded.…”

Section: Dietary Recommendations In the Early Post-ktx Periodmentioning

confidence: 99%

Nutrition Disturbances and Metabolic Complications in Kidney Transplant Recipients: Etiology, Methods of Assessment and Prevention—A Review

Górska

Kurnatowska

2022

Nutrients

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Nutrition disturbances occur at all stages of chronic kidney disease and progress with the decrease of the kidney filtration rate. Kidney transplantation (KTx) as the best form of kidney replacement therapy poses various nutritional challenges. Prior to transplantation, recipients often present with mild to advanced nutrition disturbances. A functioning allograft not only relieves uremia, acidosis, and electrolyte disturbances, but also resumes other kidney functions such as erythropoietin production and vitamin D3 metabolism. KTx recipients represent a whole spectrum of undernutrition and obesity. Since following transplantation, patients are relieved of most dietary restrictions and appetite disturbances; they resume old nutrition habits that result in weight gain. The immunosuppressive regimen often predisposes them to dyslipidemia, glucose intolerance, and hypertension. Moreover, most recipients present with chronic kidney graft disease at long-term follow-ups, usually in stages G2–G3T. Therefore, the nutritional status of KTx patients requires careful monitoring. Appropriate dietary and lifestyle habits prevent nutrition disturbances and may improve kidney graft function. Despite many nutritional guidelines and recommendations targeted at chronic kidney disease, there are few targeted at KTx recipients. We aimed to provide a brief review of nutrition disturbances and known nutritional recommendations for kidney transplant recipients based on the current literature and dietary trends.

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Electrolyte Disorders: Causes, Diagnosis, and Initial Care—Part 2

Larson,

Rogers,

Feeken

et al. 2024

Air Medical Journal

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Mechanisms and management of drug-induced hyperkalemia in kidney transplant patients

Abstract: Mechanisms and management of drug-induced hyperkalemia in kidney transplant patients.

Cited by 6 publications

References 115 publications

Fueling the success of transplantation through nutrition: recent insights into nutritional interventions, their interplay with gut microbiota and cellular mechanisms

Fueling the success of transplantation through nutrition: recent insights into nutritional interventions, their interplay with gut microbiota and cellular mechanisms

Nutrition Disturbances and Metabolic Complications in Kidney Transplant Recipients: Etiology, Methods of Assessment and Prevention—A Review

Electrolyte Disorders: Causes, Diagnosis, and Initial Care—Part 2

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