ABSTRACT
Symptomatic hyponatremia has not so far been reported as a side effect of tacrolimus. The objective of this study was to report a case of tacrolimus-induced symptomatic hyponatremia after kidney transplantation. This descriptive study was reported in an inpatient unit of Thailand. A 58-year-old man was admitted with symptomatic hyponatremia (serum sodium (SNa+) 110 mmol/L) after kidney transplantation. He was first hydrated with Normal Sterile Saline (NSS). His SNa+ increased to 118 mmol/L in 8 h, but decreased to 114 mmol/L after discontinuing NSS. Sodium bicarbonate and salt tablet were given to replace the lost sodium; furthermore, SNa+ has also dropped to 113 mmol/L. Sodium chloride (3%) was given ineffectively on days 4–9 of admission. Fludrocortisone was started at a dose of 0.05 mg once daily. Within 4 days of its administration, serum sodium slightly increased to 130 mmol/L. Therefore, administration of fludrocortisone in the case of an ineffective sodium supplement can reduce the need of intravenous saline and shorten hospital stay.
