Aldosterone Resistance Due to Tacrolimus: A Case Report

Özet

Although more common with tacrolimus, it is known that calcineurin inhibitors may induce the development of electrolytedisorders such as hyponatremia and hyperkalemia by causing a hyporeninemic hypoaldosteronism-like syndrome. We presenta 32-year-old female renal transplant patient who admitted to clinic with hyponatremia and hyperkalemia. Normal anion gapmetabolic acidosis and renal tubular dysfunction were detected and after other reasons were excluded, it was considered aselectrolyte disorder due to tacrolimus. No response was detected after tacrolimus conversion to everolimus and consideringtubular dysfunction due to aldosterone resistance, we initiated fludrocortisone therapy and electrolyte disorders rapidly improved.Fludrocortisone therapy should be considered when hyponatremia and/or hyperkalemia due to tacrolimus are detectedin renal transplant patients.