Covid-19: Indonesia becomes Asia’s new pandemic epicentre as delta variant spreads

Hyperkalemia is commonly encountered in patients who receive a renal transplant and the immunosuppressive drug, cyclosporine. There also high incidence of hypertension (which thought to be due expansion extracellular fluid volume) hyperchloremic metabolic acidosis this group patients. This constellation findings led suspicion possibility that their basis might type II hypoaldosteronism. To test hypothesis, 12 with hyperkalemia (plasma K+, 5.1 +/- 0.2 mmol/L at time study) while receiving cyclosporine were studied. Patients had diabetes mellitus, those drugs known cause (e.g., beta blockers, angiotensin-converting enzyme inhibitors, K(+)-sparing diuretics), or serum creatinine greater than 200 mumol/L excluded. The response was inappropriate because transtubular K+ concentration gradient (TTKG) only 4.3 0.4 compared TTKG 13 1, 2 h after 50 mmol KCl given normal subjects. TTKG, administration micrograms fludrocortisone, still very low (5.6 0.6) controls (12 1). After 250 500 mg acetazolamide increase delivery bicarbonate distal nephron, rose significantly 11 1 on cyclosporine, 17 controls.(ABSTRACT TRUNCATED AT WORDS)