Calcineurin Inhibitor-Induced (CNI) HTN

Question 1

Calcineurin Inhibitor-Induced (CNI) HTN

Answer 1

Cyclosporine > tacrolimus.

Question 2

Calcineurin Inhibitor-Induced (CNI) HTN

Answer 2

CNI-induced salt-sensitive HTN in mice revealed phenotype similar to familial hyperkalemic HTN (FHH), a.k.a. pseudohypoaldosteronism type II or Gordon syndrome: renal sodium (HTN) and potassium retention (hyperkalemia), RTA, hypomagnesemia, ± hypercalciuria.

Question 3

Calcineurin Inhibitor-Induced (CNI) HTN

Answer 3

Likely mechanisms: increased renal expression of the phosphorylated (active) form of the thiazide-sensitive NaCl cotransporter (NCC), along with increases in the expression of kinases that mediate activation of NCC

Question 4

Calcineurin Inhibitor-Induced (CNI) HTN

Answer 4

Likely best treated with thiazide diuretics