Stahl R A, Kanz L, Maier B, Schollmeyer P
Clin Nephrol. 1986 May;25(5):245-8.
In four out of 23 renal transplant recipients treated with cyclosporine A (CyA) and prednisone, hyperchloremic metabolic acidosis with high serum potassium was detected. The patients with metabolic acidosis had a normal anion gap and they all had a urine pH less than 6.0. Plasma renin activity (PRA) was in the low normal range and serum aldosterone in the normal range. Following reduction of the CyA dose, serum bicarbonate increased, serum chloride and serum potassium fell. None of these parameters, however, became normal. Because of morphological changes and sustained reduced renal function, two patients were switched from CyA to azathioprine plus prednisone. Within two weeks after switching, serum bicarbonate, serum chloride, and serum potassium normalized. These data suggest, that CyA induces dose dependent hyperchloremic metabolic acidosis with high serum potassium in renal transplant recipients.
在接受环孢素A（CyA）和泼尼松治疗的23例肾移植受者中，有4例检测到伴有高血钾的高氯性代谢性酸中毒。代谢性酸中毒患者的阴离子间隙正常，且他们的尿液pH均小于6.0。血浆肾素活性（PRA）处于正常低限范围，血清醛固酮在正常范围内。减少CyA剂量后，血清碳酸氢盐升高，血清氯和血清钾下降。然而，这些参数均未恢复正常。由于形态学改变和肾功能持续减退，2例患者从CyA转换为硫唑嘌呤加泼尼松治疗。转换治疗后两周内，血清碳酸氢盐、血清氯和血清钾恢复正常。这些数据表明，CyA可在肾移植受者中诱导剂量依赖性的伴有高血钾的高氯性代谢性酸中毒。
