A transplant patient treated with a calcineurin inhibitor (cyclosporine, tacrolimus, etc) may develop a transient pseudohypoaldosteronism.
Mechanism: decrease in aldosterone receptors during calcineurin inhibitor therapy
(1) renal salt-wasting
(3) metabolic acidosis
(4) normal to elevated serum aldosterone
(5) a decrease in aldosterone receptors during calcineurin inhibitor therapy
(6) normal levels of aldosterone receptors after therapy is discontinued
Aldosterone receptor expression can be determined by testing peripheral mononuclear cells with competitive RT-PCR (Heering et al).
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Specialty: Endocrinology, Clinical Laboratory, Surgery, general, Nephrology, Cardiology