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A Rare Case of Patiromer Induced Hypercalcemia
Patiromer is a calcium (Ca)-potassium (K) exchange resin approved for the treatment of hyperkalemia. Disorders of Ca or acid base balance were not reported in pre-approval clinical trials. We present a case of a patient with chronic kidney disease (CKD) with an unusual picture of hypercalcemia, meta...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396952/ https://www.ncbi.nlm.nih.gov/pubmed/34442051 http://dx.doi.org/10.3390/jcm10163756 |
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author | Kanduri, Swetha Rani Suchow, Kathryn J. Velez, Juan Carlos Q. |
author_facet | Kanduri, Swetha Rani Suchow, Kathryn J. Velez, Juan Carlos Q. |
author_sort | Kanduri, Swetha Rani |
collection | PubMed |
description | Patiromer is a calcium (Ca)-potassium (K) exchange resin approved for the treatment of hyperkalemia. Disorders of Ca or acid base balance were not reported in pre-approval clinical trials. We present a case of a patient with chronic kidney disease (CKD) with an unusual picture of hypercalcemia, metabolic alkalosis and hypokalemia upon intensification of patiromer dosing. A 56-year-old white man with CKD stage 4 (baseline creatinine 2.8 mg/dL) due to type 1 diabetes mellitus, proteinuria (1.5 g/g) and persistently high serum potassium 5.9 mEq/L attributed to type 4 renal tubular acidosis was evaluated in clinic. Due to high risk of CKD progression, patiromer 8.4 g daily, followed by 16.8 g daily was prescribed to enable renin angiotensin aldosterone system (RAAS) inhibitor. After 5 months of being on patiromer 16.8 g daily, routine laboratory tests revealed serum potassium 2.5 mEq/L, serum calcium 12.8 mg/dL and carbon dioxide 34 mEq/L. Patiromer was discontinued and thorough investigation held was negative for other causes of hypercalcemia. Five days after patiromer discontinuation, serum calcium returned to normal. The role of secondary hyperparathyroidism in this case remains unclear. We, therefore recommend cautious vigilance of patients receiving patiromer and undergoing dose escalation. |
format | Online Article Text |
id | pubmed-8396952 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-83969522021-08-28 A Rare Case of Patiromer Induced Hypercalcemia Kanduri, Swetha Rani Suchow, Kathryn J. Velez, Juan Carlos Q. J Clin Med Case Report Patiromer is a calcium (Ca)-potassium (K) exchange resin approved for the treatment of hyperkalemia. Disorders of Ca or acid base balance were not reported in pre-approval clinical trials. We present a case of a patient with chronic kidney disease (CKD) with an unusual picture of hypercalcemia, metabolic alkalosis and hypokalemia upon intensification of patiromer dosing. A 56-year-old white man with CKD stage 4 (baseline creatinine 2.8 mg/dL) due to type 1 diabetes mellitus, proteinuria (1.5 g/g) and persistently high serum potassium 5.9 mEq/L attributed to type 4 renal tubular acidosis was evaluated in clinic. Due to high risk of CKD progression, patiromer 8.4 g daily, followed by 16.8 g daily was prescribed to enable renin angiotensin aldosterone system (RAAS) inhibitor. After 5 months of being on patiromer 16.8 g daily, routine laboratory tests revealed serum potassium 2.5 mEq/L, serum calcium 12.8 mg/dL and carbon dioxide 34 mEq/L. Patiromer was discontinued and thorough investigation held was negative for other causes of hypercalcemia. Five days after patiromer discontinuation, serum calcium returned to normal. The role of secondary hyperparathyroidism in this case remains unclear. We, therefore recommend cautious vigilance of patients receiving patiromer and undergoing dose escalation. MDPI 2021-08-23 /pmc/articles/PMC8396952/ /pubmed/34442051 http://dx.doi.org/10.3390/jcm10163756 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Kanduri, Swetha Rani Suchow, Kathryn J. Velez, Juan Carlos Q. A Rare Case of Patiromer Induced Hypercalcemia |
title | A Rare Case of Patiromer Induced Hypercalcemia |
title_full | A Rare Case of Patiromer Induced Hypercalcemia |
title_fullStr | A Rare Case of Patiromer Induced Hypercalcemia |
title_full_unstemmed | A Rare Case of Patiromer Induced Hypercalcemia |
title_short | A Rare Case of Patiromer Induced Hypercalcemia |
title_sort | rare case of patiromer induced hypercalcemia |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396952/ https://www.ncbi.nlm.nih.gov/pubmed/34442051 http://dx.doi.org/10.3390/jcm10163756 |
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