Reviews & Analysis

Cinacalcet, a calcimimetic drug, is an attractive treatment for renal transplant patients who experience persistent hyperparathyroidism and hypercalcemia. In this article, however, Seikrit et al. present the case of a 47-year-old man who experienced fulminant renal allograft failure after receiving cinacalcet soon after transplantation. The authors also discuss the possible pathophysiological connection between cinacalcet administration and failure of the transplanted kidney.

This article reports the case of a 57-year-old woman who was diagnosed with primary aldosteronism after renal transplantation. The authors discuss the challenges of diagnosing this syndrome in patients with chronic kidney disease, the importance of identifying this condition owing to its association with cardiovascular risk and renal function impairment, and available treatment options.

This article considers the case of a 52-year-old man who presented with life-threatening anion gap metabolic acidosis after drinking a large quantity of vodka. The authors discuss the role of thiamine deficiency in the development of severe lactic acidosis in alcohol-dependent individuals and conclude that early intervention can lead to excellent outcomes.

This article reports the case of a 62-year-old man with end-stage renal disease on continued ambulatory peritoneal dialysis who presented with epigastric pain. Physical examination, imaging of the abdomen and cultures of peritoneal dialysis fluid led to a diagnosis of rare, fungal peritonitis caused byHistoplasma capsulatum. Removal of the peritoneal catheter and a switch to hemodialysis led to resolution of the patient's symptoms.

This article reports the case of a 36-year-old man on hemodialysis who presented to an intensive care unit with a large serum anion gap and symptoms such as hypotension and an altered mental state. For the previous 6 weeks, he had received linezolid to treat vancomycin-resistant bacteremia. Discontinuation of linezolid led to resolution of his symptoms and to normalization of the serum anion gap and serum lactate levels. The authors conclude that the patient had suffered from lactic acidosis caused by linezolid.

This article reports the case of a 49-year-old woman who presented to hospital with symptoms associated with severe hyponatremia. For the previous 6 years, she had been treated for lumbago with lumbar facet joint injections of triamcinolone acetonide every 10–12 weeks. Laboratory analyses and nonresponse to the corticotropin-releasing-hormone-stimulation test led to the conclusion that triamcinolone acetonide treatment had caused the development of secondary adrenal insufficiency, which in turn had led to upregulation of antidiuretic hormone and the development of hyponatremia.