Safety of potassium-bearing citrate in patients with renal transplantation

Abstract

Rationale:Urinary lithiasis is one of severe postoperative complications in patients undergoing renal transplantation, possibly leading to anuria, urinary infection, or even acute renal failure. Potassium sodium hydrogen citrate (PSHC), a potassium-bearing citrate, is commonly prescribed to prevent stone formation.Patient concerns:A 25-year-old man (patient 1) and a 31-year-old man (patient 2) receiving renal transplantation for end-stage renal disease (ESRD) were enrolled in this study. They were given 10 g/day of PSHC granules from the ninth day to the 17th day after surgery. Patient 1 presented chest tightness, nausea, muscle weakness, and ascending paralysis on the 10th day. Patient 2 presented weak waves on EGG on the 17th day. Moreover, their serum potassium concentrations (SPCs) were 7.67 and 6.05 mmol/L, respectively.Diagnosis:Acute hyperkalemia.Interventions:Hemo-filtration was performed for patient 1, while patient 2 received 10% calcium gluconate 10 mL, 5% NaHCO3 125 mL, and 10% glucose 500 mL with the addition of 10 units of insulin through intravenous drip.Outcomes:Their SPCs dropped to the normal range.Lessons:Physicians should pay close attentions to potential risks caused by PSHC, and monitor the SPCs to minimize the occurrence of hyperkalemia.

Citrato de potasio, tubulopatías primarias y defectos del desarrollo del esmalte

“…Adicionalmente, Wang et al reportaron riesgo de hiperkalemia en pacientes sometidos a trasplante renal y tratados con citrato de potasio. 21 Los estudios sobre los fármacos empleados en el tratamiento de patologías renales y su asociación con la aparición de DDE son escasos. A pesar de que la mayoría de los pacientes incluidos en este estudio dio inicio al tratamiento con citrato de potasio a los 2 años de edad (26,67%), período de tiempo en el cual se contempla el primer signo calcificación en incisivos centrales y primeros molares permanentes y la formación completa de la corona 9 , al realizar la estimación cronológica de la edad en la que se produjo el defecto, se presume que en el sector mayoritario (61,54%) el disturbio pudiese haberse producido al año de edad.…”

Minimal-invasive management of urological complications after kidney transplantation

“…In the acute situation, ureteral stent placement resolves hydronephrosis. Like in native kidneys, the definite treatment depends on calculi genesis: in uric acid stones, the urine alkalisation with, for example, potassium sodium hydrogen citrate (Uralyt-U ® ) seems to be safe under strict potassium monitoring in patients with normal renal function [ 80 ]. In any other stone composition, extracorporeal shock-wave lithotripsy (SWL) is an option [ 81 , 82 ].…”