Type IV RTA in Chronic Adrenal Insufficiency and Concomitant Lisinopril Treatment
Table 1
Hospital course timeline starting from day 30; medication management; serum potassium, bicarbonate, and creatinine levels.
Day of admission
Potassium (mmol/L)
Bicarbonate (mmol/L)
Creatinine (mg/dL)
30
4.0
21.6
1.2
Lisinopril 10 mg daily was restarted on day 30
31
3.6
21.9
1.3
32
3.9
21.3
1.4
33
5.5
17.5
1.5
Lisinopril discontinued due to acute kidney injury on day 33
34
5.9
19.1
1.7
TMP-SMX was switched to doxycycline; the patient received patiromer on day 34
35
6
19.6
1.4
35
6.3
19.6
1.5
Sodium bicarbonate 1300 mg three times a day was started on day 35
36
5.5
20.5
1.2
Fludrocortisone 0.1 mg daily was started on day 36
37
4.4
20.8
1.1
38
4.5
21.6
1.2
Discharge
Values of serum potassium, serum bicarbonate, and serum creatinine levels over the course of admission and treatment modifications secondary to acute kidney injury, hyperkalemia, and NAGMA. Based on our laboratory normal range, abnormal values are highlighted in bold.
