Tacrolimus-Induced Hyponatremia in Lung Transplant Recipients: A Case Series
| Autor: | Paul N. Banks, MA, Ashraf Omar, MD, Rajat Walia, MD, Sarabjit Bhalla, MD, Yun Chong, MD, Sofya Tokman, MD |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | Transplantation Direct, Vol 4, Iss 4, p e359 (2018) |
| Druh dokumentu: | article |
| ISSN: | 2373-8731 00000000 |
| DOI: | 10.1097/TXD.0000000000000774 |
| Popis: | Background. Lung transplant recipients are treated with a 3-drug immunosuppressive regimen that consists of a calcineurin inhibitor, an antiproliferative agent, and a corticosteroid. Calcineurin inhibitors are the backbone of this regimen, and tacrolimus is used more often than cyclosporine, because tacrolimus is the more potent of the two agents. Tacrolimus-induced hyponatremia has been described among kidney transplant recipients, but not among lung transplant recipients. Methods. We conducted a retrospective chart review of patients who underwent lung transplant at our institution and went on to develop severe hyponatremia. Results. We identified 5 lung transplant recipients who developed severe hyponatremia after lung transplantation (median nadir, 117 mEq/L; interquartile range, 116-119 mEq/L). Time to development of hyponatremia ranged from 3 to 85 days posttransplant. Hyponatremia persisted in these patients despite fluid restriction, salt tablets, diuretics, and fludrocortisone therapy. Hyponatremia resolved in 3 patients and significantly improved in 2 patients after they were switched from a tacrolimus-based immunosuppressive regimen to a cyclosporine-based regimen. Conclusion. Transitioning from a tacrolimus- to a cyclosporine-based immunosuppressive regimen may resolve or improve severe hyponatremia in lung transplant recipients. |
| Databáze: | Directory of Open Access Journals |
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