What causes decreased potassium excretion in patients with hyperkalemia (high serum potassium level)?

Answer

Almost all patients who present with persistent hyperkalemia have impaired renal excretion of potassium. Mild degrees of renal failure generally do not result in resting hyperkalemia, because of compensation by adaptive mechanisms in the kidneys and GI tract. However, once the GFR falls below 15-20 mL/min, significant hyperkalemia can occur, even in the absence of an abnormally large potassium load. The simple lack of nephron mass prevents normal potassium homeostasis.

Other mechanisms, such as drug effects or renal tubular acidosis, can decrease renal potassium excretion and cause hyperkalemia even in individuals with normal or only mildly decreased renal function. Two other causes of decreased excretion of potassium are reduced distal sodium delivery and reduced tubular fluid flow rate.

Medications that can decrease potassium excretion include the following:

Potassium-sparing diuretics (eg, spironolactone, triamterene, amiloride)
NSAIDs
ACE inhibitors
Angiotensin-receptor blockers (ARBs)
Cyclosporine or tacrolimus
Pentamidine
Trimethoprim-sulfamethoxazole
Heparin
Ketoconazole
Metyrapone
Herbs

In a study of 396 consecutive patients with heart failure who were taking renin-angiotensin-aldosterone system inhibitors (RAASi), 26% developed hyperkalemia of 5.5 mmol/L or greater and 12% developed hyperkalemia of 6.0 mmol/L or greater, over mean follow-up of 6.9 years. Independent risk factors for hyperkalemia included diabetes mellitus (odds ratio [OR] = 1.80, 95% CI = 1.03-3.19) and elevated baseline creatinine (OR = 2.37, 95% CI = 2.37-3.85).^[30]

Initial analysis of data on 9222 outpatients in a European heart failure registry showed that hyperkalemia was independently associated with higher mortality. After adjusting for discontinuation of RAASi discontinuation, however, hyperkalemia was no longer associated with mortality, suggesting that hyperkalemia may be a risk marker for RAASi discontinuation rather than a risk factor for worse outcomes.^[31]

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Murata K, Baumann NA, Saenger AK, Larson TS, Rule AD, Lieske JC. Relative performance of the MDRD and CKD-EPI equations for estimating glomerular filtration rate among patients with varied clinical presentations. Clin J Am Soc Nephrol. 2011 Aug. 6(8):1963-72. [Medline]. [Full Text].
Diercks DB, Shumaik GM, Harrigan RA. Electrocardiographic manifestations: electrolyte abnormalities. J Emerg Med. 2004. 27:153-160. [Medline].
Chew HC, Lim SH. Electrocardiographical case. A tale of tall T's. Hyperkalaemia. Singapore Med J. 2005 Aug. 46(8):429-32; quiz 433. [Medline].
San-Cristobal P, de los Heros P, Ponce-Coria J, et al. WNK kinases, renal ion transport and hypertension. Am J Nephrol. 2008. 28(5):860-70. [Medline].
Shaffer SG, Kilbride HW, Hayen LK, Meade VM, Warady BA. Hyperkalemia in very low birth weight infants. J Pediatr. 1992 Aug. 121(2):275-9. [Medline].
Tran HA. Extreme hyperkalemia. South Med J. 2005 Jul. 98(7):729-32. [Medline].
Kahle KT, Ring AM, Lifton RP. Molecular physiology of the WNK kinases. Annu Rev Physiol. 2008. 70:329-55. [Medline].
Huang CL, Kuo E. Mechanisms of disease: WNK-ing at the mechanism of salt-sensitive hypertension. Nat Clin Pract Nephrol. 2007 Nov. 3(11):623-30. [Medline].
Hoorn EJ, Nelson JH, McCormick JA, Ellison DH. The WNK kinase network regulating sodium, potassium, and blood pressure. J Am Soc Nephrol. 2011 Apr. 22 (4):605-14. [Medline].
Hadchouel J, Ellison DH, Gamba G. Regulation of Renal Electrolyte Transport by WNK and SPAK-OSR1 Kinases. Annu Rev Physiol. 2016. 78:367-89. [Medline].
Marino PL. Potassium. The ICU Book. Baltimore: Williams & Wilkins; 1998.
Preston RA, Afshartous D, Rodco R, Alonso AB, Garg D. Evidence for a gastrointestinal-renal kaliuretic signaling axis in humans. Kidney Int. 2015 Dec. 88 (6):1383-1391. [Medline].
Gumz ML, Rabinowitz L, Wingo CS. An Integrated View of Potassium Homeostasis. N Engl J Med. 2015 Jul 2. 373 (1):60-72. [Medline].
Bhananker SM, Ramamoorthy C, Geiduschek JM, Posner KL, Domino KB, Haberkern CM, et al. Anesthesia-related cardiac arrest in children: update from the Pediatric Perioperative Cardiac Arrest Registry. Anesth Analg. 2007 Aug. 105(2):344-50. [Medline].
Einhorn LM, Zhan M, Hsu VD, Walker LD, Moen MF, Seliger SL, et al. The frequency of hyperkalemia and its significance in chronic kidney disease. Arch Intern Med. 2009 Jun 22. 169(12):1156-62. [Medline]. [Full Text].
Raebel MA, Ross C, Xu S, et al. Diabetes and Drug-Associated Hyperkalemia: Effect of Potassium Monitoring. J Gen Intern Med. 2010 Jan 20. [Medline]. [Full Text].
Johnson ES, Weinstein JR, Thorp ML, et al. Predicting the risk of hyperkalemia in patients with chronic kidney disease starting lisinopril. Pharmacoepidemiol Drug Saf. 2010 Mar. 19(3):266-72. [Medline].
Lin HH, Yang YF, Chang JK, et al. Renin-angiotensin system blockade is not associated with hyperkalemia in chronic hemodialysis patients. Ren Fail. 2009. 31(10):942-5. [Medline].
Weir MR, Rolfe M. Potassium homeostasis and Renin-Angiotensin-aldosterone system inhibitors. Clin J Am Soc Nephrol. 2010 Mar. 5(3):531-48. [Medline].
Preston RA, Afshartous D, Garg D, et al. Mechanisms of impaired potassium handling with dual renin-angiotensin-aldosterone blockade in chronic kidney disease. Hypertension. 2009 Mar 23. [Medline].
Khanna A, White WB. The management of hyperkalemia in patients with cardiovascular disease. Am J Med. 2009 Mar. 122(3):215-21. [Medline].
Schweiger B, Moriarty MW, Cadnapaphornchai MA. Case report: severe neonatal hyperkalemia due to pseudohypoaldosteronism type 1. Curr Opin Pediatr. 2009 Apr. 21(2):269-71. [Medline].
Papaioannou V, Dragoumanis C, Theodorou V, Pneumatikos I. The propofol infusion 'syndrome' in intensive care unit: from pathophysiology to prophylaxis and treatment. Acta Anaesthesiol Belg. 2008. 59(2):79-86. [Medline].
Matthews JM. Succinylcholine-induced hyperkalemia. Anesthesiology. 2006 Aug. 105(2):430; author reply 431. [Medline].
Piotrowski AJ, Fendler WM. Hyperkalemia and cardiac arrest following succinylcholine administration in a 16-year-old boy with acute nonlymphoblastic leukemia and sepsis. Pediatr Crit Care Med. 2007 Mar. 8(2):183-5. [Medline].
Gronert GA, Theye RA. Pathophysiology of hyperkalemia induced by succinylcholine. Anesthesiology. 1975 Jul. 43(1):89-99. [Medline]. [Full Text].
Perazella MA, Biswas P. Acute hyperkalemia associated with intravenous epsilon-aminocaproic acid therapy. Am J Kidney Dis. 1999 Apr. 33(4):782-5. [Medline].
Carroll HJ, Tice DA. The effects of epsilon amino-caproic acid upon potassium metabolism in the dog. Metabolism. 1966 May. 15(5):449-57. [Medline].
Mattu A, Brady WJ, Robinson DA. Electrocardiographic manifestations of hyperkalemia. Am J Emerg Med. 2000 Oct. 18(6):721-9. [Medline].
Martens P, Kooij J, Maessen L, Dauw J, Dupont M, Mullens W. The importance of developing hyperkalaemia in heart failure during long-term follow-up. Acta Cardiol. 2020 Apr 8. 1-9. [Medline].
Rossignol P, et al; Heart Failure Long-Term Registry Investigators Group. Unravelling the interplay between hyperkalaemia, renin-angiotensin-aldosterone inhibitor use and clinical outcomes. Data from 9222 chronic heart failure patients of the ESC-HFA-EORP Heart Failure Long-Term Registry. Eur J Heart Fail. 2020 Apr 3. [Medline].
Sánchez-Carpintero I, Ruiz-Rodriguez R, López-Gutiérrez JC. [Propranolol in the treatment of infantile hemangioma: clinical effectiveness, risks, and recommendations]. Actas Dermosifiliogr. 2011 Dec. 102(10):766-79. [Medline].
Pavlakovic H, Kietz S, Lauerer P, Zutt M, Lakomek M. Hyperkalemia complicating propranolol treatment of an infantile hemangioma. Pediatrics. 2010 Dec. 126(6):e1589-93. [Medline].
Cummings CC, McIvor ME. Fluoride-induced hyperkalemia: the role of Ca2+-dependent K+ channels. Am J Emerg Med. 1988 Jan. 6(1):1-3. [Medline].
Suzuki H, Terai M, Hamada H, Honda T, Suenaga T, Takeuchi T, et al. Cyclosporin A treatment for Kawasaki disease refractory to initial and additional intravenous immunoglobulin. Pediatr Infect Dis J. 2011 Oct. 30(10):871-6. [Medline].
Nowicki TS, Bjornard K, Kudlowitz D, Sandoval C, Jayabose S. Early recognition of renal toxicity of high-dose methotrexate therapy: a case report. J Pediatr Hematol Oncol. 2008 Dec. 30(12):950-2. [Medline].
Gowda RM, Cohen RA, Khan IA. Toad venom poisoning: resemblance to digoxin toxicity and therapeutic implications. Heart. 2003 Apr. 89(4):e14. [Medline]. [Full Text].
New MI. Inborn errors of adrenal steroidogenesis. Mol Cell Endocrinol. 2003. 211:75-83. [Medline].
White PC. Aldosterone synthase deficiency and related disorders. Mol Cell Endocrinol. 2004. 217:81-87. [Medline].
Sartorato P, Khaldi Y, Lapeyraque AL, et al. Inactivating mutations of the mineralocorticoid receptor in Type I pseudohypoaldosteronism. Mol Cell Endocrinol. 2004 Mar 31. 217(1-2):119-25. [Medline].
Geller DS, Rodriguez-Soriano J, Vallo Boado A, Schifter S, Bayer M, Chang SS, et al. Mutations in the mineralocorticoid receptor gene cause autosomal dominant pseudohypoaldosteronism type I. Nat Genet. 1998 Jul. 19(3):279-81. [Medline].
Gamba G. Role of WNK kinases in regulating tubular salt and potassium transport and in the development of hypertension. Am J Physiol Renal Physiol. 2005. 288:F245-52. [Medline]. [Full Text].
Boyden LM, Choi M, Choate KA, Nelson-Williams CJ, Farhi A, Toka HR, et al. Mutations in kelch-like 3 and cullin 3 cause hypertension and electrolyte abnormalities. Nature. 2012 Jan 22. 482(7383):98-102. [Medline]. [Full Text].
Muhammad E, Leventhal N, Parvari G, Hanukoglu A, Hanukoglu I, Chalifa-Caspi V, et al. Autosomal recessive hyponatremia due to isolated salt wasting in sweat associated with a mutation in the active site of Carbonic Anhydrase 12. Hum Genet. 2011 Apr. 129(4):397-405. [Medline].
Jurkat-Rott K, Mitrovic N, Hang C, Kouzmekine A, Iaizzo P, Herzog J, et al. Voltage-sensor sodium channel mutations cause hypokalemic periodic paralysis type 2 by enhanced inactivation and reduced current. Proc Natl Acad Sci U S A. 2000 Aug 15. 97(17):9549-54. [Medline]. [Full Text].
Lorenz JM, Kleinman LI, Markarian K. Potassium metabolism in extremely low birth weight infants in the first week of life. J Pediatr. 1997 Jul. 131(1 Pt 1):81-6. [Medline].
Jarman PR, Kehely AM, Mather HM. Hyperkalaemia in diabetes: prevalence and associations. Postgrad Med J. 1995 Sep. 71(839):551-2. [Medline]. [Full Text].
Reardon LC, Macpherson DS. Hyperkalemia in outpatients using angiotensin-converting enzyme inhibitors. How much should we worry?. Arch Intern Med. 1998 Jan 12. 158(1):26-32. [Medline]. [Full Text].
Maggioni AP, Greene SJ, Fonarow GC, Böhm M, Zannad F, Solomon SD, et al. Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial. Eur Heart J. 2013 Oct. 34(40):3117-27. [Medline]. [Full Text].
Gheorghiade M, Böhm M, Greene SJ, Fonarow GC, Lewis EF, Zannad F, et al. Effect of aliskiren on postdischarge mortality and heart failure readmissions among patients hospitalized for heart failure: the ASTRONAUT randomized trial. JAMA. 2013 Mar 20. 309(11):1125-35. [Medline].
Mann JF, Anderson C, Gao P, Gerstein HC, Boehm M, Rydén L, et al. Dual inhibition of the renin-angiotensin system in high-risk diabetes and risk for stroke and other outcomes: results of the ONTARGET trial. J Hypertens. 2013 Feb. 31(2):414-21. [Medline].
Juurlink DN, Mamdani MM, Lee DS. Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. N Engl J Med. 2004. 351:543-551. [Medline]. [Full Text].
Paice B, Gray JM, McBride D. Hyperkalaemia in patients in hospital. Br Med J (Clin Res Ed). 1983 Apr 9. 286(6372):1189-92. [Medline]. [Full Text].
Gurnaney H, Brown A, Litman RS. Malignant hyperthermia and muscular dystrophies. Anesth Analg. 2009 Oct. 109(4):1043-8. [Medline].
Segura J, Ruilope LM. Hyperkalemia risk and treatment of heart failure. Heart Fail Clin. 2008 Oct. 4(4):455-64. [Medline].
Weisberg LS. Management of severe hyperkalemia. Crit Care Med. 2008 Dec. 36(12):3246-51. [Medline].
Hughes-Austin JM, Rifkin DE, Beben T, Katz R, Sarnak MJ, Deo R, et al. The Relation of Serum Potassium Concentration with Cardiovascular Events and Mortality in Community-Living Individuals. Clin J Am Soc Nephrol. 2017 Feb 7. 12 (2):245-252. [Medline].
Braden GL, O'Shea MH, Mulhern JG, et al. Acute renal failure and hyperkalaemia associated with cyclooxygenase-2 inhibitors. Nephrol Dial Transplant. 2004 May. 19(5):1149-53. [Medline]. [Full Text].
Schepkens H, Vanholder R, Billiouw JM, Lameire N. Life-threatening hyperkalemia during combined therapy with angiotensin-converting enzyme inhibitors and spironolactone: an analysis of 25 cases. Am J Med. 2001 Apr 15. 110(6):438-41. [Medline].
Zietse R, Zoutendijk R, Hoorn EJ. Fluid, electrolyte and acid-base disorders associated with antibiotic therapy. Nat Rev Nephrol. 2009 Apr. 5(4):193-202. [Medline].
Kamel KS, Halperin ML. Intrarenal urea recycling leads to a higher rate of renal excretion of potassium: an hypothesis with clinical implications. Curr Opin Nephrol Hypertens. 2011 Sep. 20(5):547-54. [Medline].
Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999 Mar 16. 130(6):461-70. [Medline].
Watson M, Abbott KC, Yuan CM. Damned if you do, damned if you don't: potassium binding resins in hyperkalemia. Clin J Am Soc Nephrol. 2010 Oct. 5(10):1723-6. [Medline].
[Guideline] Alfonzo A, Soar J, MacTier R, et al. Treatment of Acute Hyperkalaemia in Adults. The Renal Association. Available at http://www.renal.org/guidelines/joint-guidelines/treatment-of-acute-hyperkalaemia-in-adults#sthash.vXcD0IG3.QqdB4c5G.dpbs. March 1, 2014; Accessed: October 6, 2015.
Elliott MJ, Ronksley PE, Clase CM, Ahmed SB, Hemmelgarn BR. Management of patients with acute hyperkalemia. CMAJ. 2010 Oct 19. 182 (15):1631-5. [Medline]. [Full Text].
Sterns RH, Rojas M, Bernstein P, Chennupati S. Ion-exchange resins for the treatment of hyperkalemia: are they safe and effective?. J Am Soc Nephrol. 2010 May. 21(5):733-5. [Medline].
Pierce DA, Russell G, Pirkle JL Jr. The Incidence of Hypoglycemia in Patients With Low eGFR Treated With Insulin and Dextrose for Hyperkalemia. Ann Pharmacother. 2015 Sep 28. [Medline].
Dick TB, Raines AA, Stinson JB, Collingridge DS, Harmston GE. Fludrocortisone is effective in the management of tacrolimus-induced hyperkalemia in liver transplant recipients. Transplant Proc. 2011 Sep. 43(7):2664-8. [Medline].
Rogers FB, Li SC. Acute colonic necrosis associated with sodium polystyrene sulfonate (Kayexalate) enemas in a critically ill patient: case report and review of the literature. J Trauma. 2001 Aug. 51(2):395-7. [Medline].
McGowan CE, Saha S, Chu G, Resnick MB, Moss SF. Intestinal necrosis due to sodium polystyrene sulfonate (Kayexalate) in sorbitol. South Med J. 2009 May. 102(5):493-7. [Medline]. [Full Text].
US Food and Drug Administration. Safety: Kayexalate (sodium polystyrene sulfonate) powder. Available at http://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm186845.htm. Accessed: October 5, 2015.
Harel Z, Harel S, Shah PS, Wald R, Perl J, Bell CM. Gastrointestinal adverse events with sodium polystyrene sulfonate (Kayexalate) use: a systematic review. Am J Med. 2013 Mar. 126(3):264.e9-24. [Medline].
Bakris GL, Pitt B, Weir MR, Freeman MW, Mayo MR, Garza D, et al. Effect of Patiromer on Serum Potassium Level in Patients With Hyperkalemia and Diabetic Kidney Disease: The AMETHYST-DN Randomized Clinical Trial. JAMA. 2015 Jul 14. 314 (2):151-61. [Medline].
Pitt B, Bakris GL, Bushinsky DA, Garza D, Mayo MR, Stasiv Y, et al. Effect of patiromer on reducing serum potassium and preventing recurrent hyperkalaemia in patients with heart failure and chronic kidney disease on RAAS inhibitors. Eur J Heart Fail. 2015 Oct. 17 (10):1057-65. [Medline].
Kosiborod M, Rasmussen HS, Lavin P, Qunibi WY, Spinowitz B, Packham D, et al. Effect of sodium zirconium cyclosilicate on potassium lowering for 28 days among outpatients with hyperkalemia: the HARMONIZE randomized clinical trial. JAMA. 2014 Dec 3. 312 (21):2223-33. [Medline]. [Full Text].
Anker SD, Kosiborod M, Zannad F, Piña IL, McCullough PA, Filippatos G, et al. Maintenance of serum potassium with sodium zirconium cyclosilicate (ZS-9) in heart failure patients: results from a phase 3 randomized, double-blind, placebo-controlled trial. Eur J Heart Fail. 2015 Oct. 17 (10):1050-6. [Medline]. [Full Text].
Khedr E, Abdelwhab S, El-Sharkay M, et al. Prevalence of hyperkalemia among hemodialysis patients in Egypt. Ren Fail. 2009. 31(10):891-8. [Medline].
Bercovitz RS, Greffe BS, Hunger SP. Acute tumor lysis syndrome in a 7-month-old with hepatoblastoma. Curr Opin Pediatr. 2010 Feb. 22(1):113-6. [Medline].
Schafers S, Naunheim R, Vijayan R. Incidence of hypoglycemia following insulin-based acute stabilization of hyperkalemia treatment. J Hospit Med. 15 Nov 2011. Early online:
An JN, Lee JP, Jeon HJ, Kim DH, Oh YK, Kim YS, et al. Severe hyperkalemia requiring hospitalization: predictors of mortality. Crit Care. 2012 Nov 21. 16(6):R225. [Medline].
Cheng CJ, Lin CS, Chang LW, et al. Perplexing hyperkalaemia. Nephrol Dial Transplant. 2006 Nov. 21(11):3320-3. [Medline]. [Full Text].
Fordjour KN, Walton T, Doran JJ. Management of Hyperkalemia in Hospitalized Patients. Am J Med Sci. 2012 Dec 18. [Medline].

Media Gallery

Widened QRS complexes in patient whose serum potassium level was 7.8 mEq/L.
ECG of patient with pretreatment potassium level of 7.8 mEq/L and widened QRS complexes after receiving 1 ampule of calcium chloride. Note narrowing of QRS complexes and reduction of T waves.
Hyperkalemia diagnosis and treatment flow chart.
Widened QRS complexes in hyperkalemia.

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Author

Eleanor Lederer, MD, FASN Professor of Medicine, Chief, Nephrology Division, Director, Nephrology Training Program, Director, Metabolic Stone Clinic, Kidney Disease Program, University of Louisville School of Medicine; Consulting Staff, Louisville Veterans Affairs Hospital

Eleanor Lederer, MD, FASN is a member of the following medical societies: American Association for the Advancement of Science, American Federation for Medical Research, American Society for Biochemistry and Molecular Biology, American Society for Bone and Mineral Research, American Society of Nephrology, American Society of Transplantation, International Society of Nephrology, Kentucky Medical Association, National Kidney Foundation, Phi Beta Kappa

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: American Society of Nephrology<br/>Received income in an amount equal to or greater than $250 from: Healthcare Quality Strategies, Inc<br/>Received grant/research funds from Dept of Veterans Affairs for research; Received salary from American Society of Nephrology for asn council position; Received salary from University of Louisville for employment; Received salary from University of Louisville Physicians for employment; Received contract payment from American Physician Institute for Advanced Professional Studies, LLC for independent contractor; Received contract payment from Healthcare Quality Strategies, Inc for independent cont.

Coauthor(s)

Zygimantas C Alsauskas, MD Assistant Professor of Medicine, Division of Nephrology, Kidney Disease Program, University of Louisville School of Medicine

Zygimantas C Alsauskas, MD is a member of the following medical societies: American Society of Nephrology

Disclosure: Nothing to disclose.

Lina Mackelaite, MD Assistant Professor of Medicine, University of Louisville School of Medicine

Lina Mackelaite, MD is a member of the following medical societies: American Society of Hypertension, American Society of Nephrology, American Society of Transplantation, National Kidney Foundation

Disclosure: Nothing to disclose.

Vibha Nayak, MD Assistant Professor of Nephrology, Director of Home Dialysis, Kidney Disease Program, University of Louisville School of Medicine

Vibha Nayak, MD is a member of the following medical societies: American Society of Nephrology

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Vecihi Batuman, MD, FASN Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Renal Section, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, International Society of Nephrology, Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Acknowledgements

Son Dinh, MD Nephrologist, Southland Renal Medical Group, Inc

Son Dinh, MD is a member of the following medical societies: American Society of Nephrology and National Kidney Foundation

Disclosure: Nothing to disclose.

Anil Kumar Mandal, MD Clinical Professor, Department of Internal Medicine, Division of Nephrology, University of Florida School of Medicine

Anil Kumar Mandal, MD is a member of the following medical societies: American College of Clinical Pharmacology, American College of Physicians, American Society of Nephrology, and Central Society for Clinical Research

Disclosure: Nothing to disclose.

Rosemary Ouseph, MD Professor of Medicine, Director of Kidney Transplant, University of Louisville School of Medicine

Rosemary Ouseph, MD is a member of the following medical societies: American Society for Bone and Mineral Research, American Society of Nephrology, and American Society of Transplant Surgeons

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Christie P Thomas, MBBS, FRCP, FASN, FAHA Professor, Department of Internal Medicine, Division of Nephrology, Medical Director, Kidney and Kidney/Pancreas Transplant Program, University of Iowa Hospitals and Clinics

Christie P Thomas, MBBS, FRCP, FASN, FAHA is a member of the following medical societies: American College of Physicians, American Heart Association, American Society of Nephrology, and Royal College of Physicians

Disclosure: Nothing to disclose.

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