Correction of renal hypertension after kidney transplantation from a donor with Gitelman syndrome.

Abstract

The relationship between the kidney and blood pressure control is complex. Monogenetic forms of hypertension have recently been identified that implicate specific mutations responsible for blood pressure control. The thiazide sensitive Na-Cl cotransporter (NCC) has been implicated in the control of blood pressure, however a direct link between the kidney NCC and blood pressure regulation is lacking. Here, we report a case of chimerism in which a kidney from a patient with Gitelman syndrome was transplanted into a non-Gitelman hypertensive recipient. After transplantation, postural hypotension resulted, necessitating discontinuation of all antihypertensive medications used for treatment of calcineurin-induced hypertension. This is the first reported case of acquired Gitelman syndrome after transplantation. Transplantation of a Gitelman "kidney" into a hypertensive recipient provides additional support for the role of the kidney NCC in blood pressure regulation. Furthermore, this case suggests the potential use of thiazide diuretics in the treatment of calcineurin-induced hypertension.

• Authors: Daniel C Hu, Christopher Burtner, Anna Hong, Peter I Lobo, Mark D Okusa
• Journal: The American journal of the medical sciences (Am J Med Sci) Vol. 331 Issue 2 Pg. 105-9 (Feb 2006) ISSN: 0002-9629 [Print] United States
• PMID: 16479187 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antihypertensive Agents
• Receptors, Drug
• Sodium Chloride Symporters
• thiazide receptor

Topics

• Antihypertensive Agents (administration & dosage, therapeutic use)
• Female
• Humans
• Hypertension, Renal (drug therapy)
• Hypotension (genetics)
• Kidney Transplantation
• Male
• Middle Aged
• Receptors, Drug (genetics)
• Sodium Chloride Symporters (genetics)
• Syndrome
• Tissue Donors
• Treatment Outcome