|
所属 |
医学部 附属病院 腎臓内科 |
|
職名 |
助教 |
|
関連SDGs |
|
論文 【 表示 ／ 非表示 】
-
Effect of Antihypertensive Drugs on Rapid Decline in Estimated Glomerular Filtration Rate in Japanese Patients with Chronic Kidney Disease. 査読あり
Fujimoto K, Kikuchi M, Nakai M, Konta T, Iseki K, Tsuruya K, Yamagata K, Narita I, Moriyama T, Shibagaki Y, Kasahara M, Kondo M, Asahi K, Watanabe T, Kaikita K, Fujimoto S
American journal of hypertension 2025年3月
-
Fujimoto K, Hisanaga S, Kuroda S, Kodama K, Sugiyama F, Kikuchi M, Kita T, Yamashita A, Nagai T, Kamimura T, Kaikita K, Imamura T, Fujimoto S
CEN case reports 13 ( 1 ) 1 - 8 2023年4月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：CEN Case Reports
A 42-year-old man showed marked hypokalemia after kidney transplantation. He was diagnosed with hypertension and suffered from acute myocardial infarction at 33 and 38 years of age. At 40 years of age, hemodialysis was introduced. A left adrenal tumor was noted and suspected as a non-functional adrenal adenoma at that time. Therefore, he received a living-donor kidney transplant at 42 years of age. After kidney transplantation, the serum creatinine level dropped. His blood pressure remained high, and the serum potassium level decreased. The PRA and PAC were elevated, and ARR was not elevated. Based on the results of various confirmatory tests and vein sampling, he was diagnosed with excessive secretion of renin from the native kidneys that was complicated by primary aldosteronism (PA), and left nephrectomy and adrenalectomy were performed. The overproduction of aldosterone in the resected adrenal adenoma and over secretion of renin in the kidney with arteriolosclerosis were immunohistologically confirmed. After surgery, the PAC decreased, but the PRA did not decrease. The postoperative serum potassium level improved, and the blood pressure was well controlled with a small dose of medication. This is the first reported case of PA with hyperreninemia after kidney transplantation. It should be noted that PA in dialysis patients and kidney transplant recipients may not fulfill the usual diagnostic criteria of an elevated ARR. In such patients, PA should be suspected based on the absolute value of the PAC and responsiveness to ACTH stimulation, and adrenal and renal vein sampling is required for a definitive diagnosis.