Successful treatment of hyperkalemic quadriplegia associated with spironolactone.
Hyperkalemic flaccid quadriplegia and cardiotoxic disturbances developed during antihypertensive therapy with spironolactone in a 76-year-old woman with chronic renal insufficiency. Hyperkalemia was successfully overcome and followed by the disappearance of all cardiac and muscular disorders. Progression of the renal disease leading to a decrease of creatinine clearance from 85 ml/min to 4.5 ml/min, during a three-year observation period per se had apparently no influence on the serum level of potassium. Our studies suggested that no primary insufficiency of the renin-aldosterone and glucocorticoid systems had been responsible for the hyperkalemia, therefore, it could be contributed entirely to the effect of spironolactone abolishing the K+ secreting capacity of the already decreased renal mass. Further studies revealed that blocking action of the drug on H+ secretion ("renal tubular acidosis") may also have had a role-in addition to the K+ retention-in the development of the spironolactone-induced hyperkalemia.
Radó
J P
JP
Department of Medicine, Emil Weil Hospital, Budapest, Hungary.
D000136:Acid-Base Equilibrium / Q000187:drug effects; D000368:Aged; D000450:Aldosterone / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D004562:Electrocardiography; D004573:Electrolytes / Q000097:blood; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000150:complications / Q000188:drug therapy*; D007328:Insulin / Q000097:blood; D011782:Quadriplegia / Q000188:drug therapy* / Q000209:etiology; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000187:drug effects; D013148:Spironolactone / Q000627:therapeutic use*
D001786:Blood Glucose; D004573:Electrolytes; D007328:Insulin; D013148:Spironolactone; D000450:Aldosterone; D012083:Renin