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Hyperkalemia After Renal TransplantationOccurrence in a Patient With Insulin-Dependent Diabetes
Robert Rosenbaum, MD;
Phillip E. Hoffsten, MD;
Philip Cryer, MD;
Saulo Klahr, MD
Arch Intern Med. 1978;138(8):1270-1272.
Abstract
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An insulin-dependent diabetic patient received a renal transplant from a living related donor without evidence of rejection. In the posttransplant period, his serum potassium concentration (3.7 to 6.7 mEq/liter) fluctuated widely with the serum glucose concentration (165 to 470 mg/dl) during the day. Serum glucose and potassium concentrations were directly correlated (r =.734, P.001). Other factors controlling the serum potassium concentration were examined. Plasma and urinary aldosterone levels were normal, plasma renin activity and aldosterone levels rose during upright activity, and urinary potassium excretion increased with the administration of exogenous mineralocorticoid. Thus, mineralocorticoid secretion and responsiveness were intact.
These observations indicate that hyperkalemia in a diabetic patient can occur in the absence of a defect in potassium excretion and are consistent with the interpretation that insulinopenia, as evidenced by hyperglycemia, can result in hyperkalemia due to diminished translocation of both potassium and glucose from the extracellular to the intracellular compartment.
(Arch Intern Med 138:1270-1272, 1978)
Author Affiliations
From the Renal Division, Department of Medicine and the Clinical Research Center, Washington University School of Medicine, St Louis.
Footnotes
Accepted for publication Oct 27, 1977.
Reprint requests to Renal Division, Department of Medicine, Washington University School of Medicine 4550 Scott Ave, St Louis, MO 53110 (Dr Klahr).
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ABSTRACT
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