Solid organ transplant recipients display a variety of electrolyte abnormalities in the early months after transplant surgery that need to be monitored, according to investigators presenting at the National Kidney Foundation’s 2022 Spring Clinical Meetings being held in Boston, Massachusetts.

Investigators examined the electronic health records of 199 recipients treated at Westchester Medical Center in Valhalla, New York during 2019 to 2021. Hypomagnesemia increased significantly 3 months after transplant, affecting 68.6% of liver, 50.9% of kidney, and 41.7% of heart transplant recipients. Medication administered after transplantation was a likely contributor, George Coritsidis, MD, and colleagues reported in a poster presentation. Use of calcineurin inhibitors, steroids, diuretics, and proton pump inhibitors have been linked to hypomagnesemia in the early post-transplant period. Hypomagnesemia has been reported to be more frequent in patients that were treated with the calcineurin inhibitor tacrolimus than cyclosporine, according to the investigators. All recipients in this study were taking tacrolimus and magnesium supplements, 71% took proton pump inhibitors, and 58% loop diuretics.

In a separate study published in Kidney and Blood Pressure, Ofer Isakov, MD, PhD, of Tel Aviv Souraski Medical Center, Tel Aviv University, Israel, and colleagues suggested that hypomagnesemia occurring early after transplant may indicate better tubular graft function.

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In the current study, hypercalcemia also significantly increased at 3 months in kidney transplant recipients, possibly as a result of hyperparathyroidism, according to the investigators.

There were no significant differences between groups in hyperkalemia or hypokalemia incidence.

“Awareness of electrolyte abnormalities, particularly persistent hypomagnesemia may influence post-Tx management for arrhythmias,” according to Dr Coritsidis’ team.


Coritsidis G, Durosier M, Narula J, Fan H, Okoro-sokoh J, Fullmer JC. The early prevalence, risk factors and predictors of electrolyte abnormalities in solid organ transplant. Presented at the National Kidney Foundation 2022 Spring Clinical Meetings, Boston, Massachusetts, April 6-10, 2022. Poster 299.

Obayomi M, Narula J, Durosier M, Fullmer J, Fan H, Okoro J. Risk Factors of Hypomagnesemia in Solid Organ Transplants. Presented at the National Kidney Foundation 2022 Spring Clinical Meetings, April 6-10, 2022. Poster 413.