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Effects of Cyclosporine on the Renin-Angiotensin-Aldosterone System and Potassium Excretion in Renal Transplant Recipients

John P. Bantle, MD; Karl A. Nath, MD; David E. R. Sutherland, MD; John S. Najarian, MD; Thomas F. Ferris, MD
Arch Intern Med. 1985;145(3):505-508. doi:10.1001/archinte.1985.00360030153026.
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• To evaluate the mechanism of cyclosporine-induced hyperkalemia, the renin-angiotensin-aldosterone system and renal potassium clearance were compared in ten renal transplant recipients treated with cyclosporine and treated with azathioprine. After stimulation by a low-sodium diet and furosemide, cyclosporine-treated patients demonstrated lower plasma renin activity when supine (1.9 ±0.3 v 7.8± 1.4 ng/mL/hr) and after standing (0.3±0.7 v 12.2±1.5 ng/ mL/hr). Supine plasma aldosterone levels tended to be lower in cyclosporine-treated patients, (4.8 ±0.8 v 10.5±2.6 ng/dL), although standing plasma aldosterone levels were not different (10.8 ±3.0 v 12.3 ±2.0 ng/dL). After administration of 0.75 mEq of potassium chloride per kilogram of body weight, cyclosporine-treated patients excreted 52%±7.1% of the potassium load in six hours compared with excretion of 67%±7.0% by the azathioprine-treated patients, although there was no difference in plasma aldosterone levels in response to the potassium load in the two groups. These data suggest that cyclosporine causes suppression of


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