Safety of potassium-bearing citrate in patients with renal transplantation: A case report

• Published in: Medicine (Baltimore) 2017-10, Vol.96 (42), p.e6933-e6933
• Main Authors: Wang, Lin, Cui, Yinglin, Zhang, Jianwei, Zhang, Qinsheng
• Format: Article
• Language: English
• Subjects: Adult; Clinical Case Report; Diuretics - administration & dosage; Diuretics - adverse effects; Humans; Hyperkalemia - chemically induced; Kidney Transplantation - adverse effects; Male; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Potassium Citrate - administration & dosage; Potassium Citrate - adverse effects; Urolithiasis - etiology; Urolithiasis - prevention & control
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000006933

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. 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. Acute hyperkalemia. 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. Their SPCs dropped to the normal range. Physicians should pay close attentions to potential risks caused by PSHC, and monitor the SPCs to minimize the occurrence of hyperkalemia.