[Hypokalemia, hypovolemia and electrocardiographic changes due to furosemide abuse. Report of one case].
Hypokalemia (serum K+ < 3.5 mEq/1) is a potentially serious adverse effect of diuretic ingestion. We report a 27 year-old woman admitted with muscle weakness, a serum potassium of 2.0 mEq/1, metabolic alkalosis and EKG abnormalities simulating cardiac ischemia, that reverted with potassium chloride administration. She admitted high dose furosemide self-medication for edema. Glomerular filtration rate, tubular sodium reabsorption, potassium secretion, the renin-aldosterone system, total body water distribution and capillary permeability, were studied sequentially until 90 days after her admission. There was hyperactivity of the renin-aldosterone axis, reduction in extracellular and intracellular volumes, normal capillary permeability and high sodium tubular reabsorption, probably explained by a "rebound" salt retention associated with her decreased extracellular volume.
Aravena
César
C
Departamento de Nefrología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Salas
Ignacio
I
Tagle
Rodrigo
R
Jara
Aquiles
A
Miranda
Rodrigo
R
McNab
Paul
P
Rodríguez
José A
JA
Valdés
Gloria
G
Valdivieso
Andrés
A
D000328:Adult; D004232:Diuretics / Q000009:adverse effects*; D004487:Edema / Q000188:drug therapy; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D005665:Furosemide / Q000009:adverse effects*; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced*; D020896:Hypovolemia / Q000139:chemically induced*; D011189:Potassium Chloride / Q000627:therapeutic use; D012651:Self Medication / Q000009:adverse effects*
D004232:Diuretics; D011189:Potassium Chloride; D005665:Furosemide