Aboghanem A, Prasad GVR. Disorders of potassium homeostasis after kidney transplantation. World J Transplant 2024; 14(3): 95905 [PMID: 39295980 DOI: 10.5500/wjt.v14.i3.95905]
Corresponding Author of This Article
G V Ramesh Prasad, MBBS, PhD, Professor, Staff Physician, Kidney Transplant Program, Michael's Hospital, No. 61 Queen Street East, Toronto M5C 2T2, Ontario, Canada. ramesh.prasad@unityhealth.to
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Sep 18, 2024; 14(3): 95905 Published online Sep 18, 2024. doi: 10.5500/wjt.v14.i3.95905
Disorders of potassium homeostasis after kidney transplantation
Abdelhamid Aboghanem, G V Ramesh Prasad
Abdelhamid Aboghanem, G V Ramesh Prasad, School of Medicine, University of Toronto, Toronto M5C 2T2, Ontario, Canada
G V Ramesh Prasad, Kidney Transplant Program, St. Michael's Hospital, Toronto M5C 2T2, Ontario, Canada
Author contributions: Aboghanem A critically reviewed and appraised the literature and wrote the paper; Prasad GVR designed the study, critically reviewed and appraised the literature, and wrote the paper. Both authors read and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflict of interest to declare in relation to the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: G V Ramesh Prasad, MBBS, PhD, Professor, Staff Physician, Kidney Transplant Program, Michael's Hospital, No. 61 Queen Street East, Toronto M5C 2T2, Ontario, Canada. ramesh.prasad@unityhealth.to
Received: April 21, 2024 Revised: May 29, 2024 Accepted: June 26, 2024 Published online: September 18, 2024 Processing time: 100 Days and 9.9 Hours
Abstract
Disturbances of potassium balance are often encountered when managing kidney transplant recipients (KTR). Both hyperkalemia and hypokalemia may present either as medical emergencies or chronic outpatient abnormalities. Despite the high incidence of hyperkalemia and its potential life-threatening implications, consensus on its management in KTR is lacking. Hypokalemia in KTR is also well-described, although it is given less attention by clinicians compared to hyperkalemia. This article discusses the etiology, pathophysiology and management of both types of potassium disorders in KTR. Once any emergent situation has been corrected, treatment approaches include correcting insulin deficiency if present, adjusting non-immunosuppressive and immunosuppressive medications, eliminating or supplementing potassium as needed, and dietary counselling. Although commonly of multifactorial etiology, ascertaining the specific cause in a particular patient will help guide successful management. Monitoring KTR through regular laboratory testing is essential to detect serious disturbances in potassium balance since patients are often asymptomatic.
Core Tip: Both hyperkalemia and hypokalemia are usually asymptomatic in kidney transplant recipients but can lead to serious morbidity, so regular monitoring is needed. Since medications are a common cause, dose adjustments or medication changes are often required.
