title: [Hypokalemia, hypovolemia and electrocardiographic changes due to furosemide abuse. Report of one case].
abstract: 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.
authors.affiliation: Departamento de Nefrología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: César
authors.initials: C
authors.lastname: Aravena
authors.forename: Ignacio
authors.initials: I
authors.lastname: Salas
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Tagle
authors.forename: Aquiles
authors.initials: A
authors.lastname: Jara
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Miranda
authors.forename: Paul
authors.initials: P
authors.lastname: McNab
authors.forename: José A
authors.initials: JA
authors.lastname: Rodríguez
authors.forename: Gloria
authors.initials: G
authors.lastname: Valdés
authors.forename: Andrés
authors.initials: A
authors.lastname: Valdivieso
mesh_terms: 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*
chemical_list: D004232:Diuretics; D011189:Potassium Chloride; D005665:Furosemide