Brief report: trimethoprim-induced hyperkalemia in a patient with AIDS
Article Abstract:
Patients with AIDS may develop hyperkalemia after being treated with high doses of trimethoprim for Pneumocystis carinii pneumonia. Hyperkalemia is a disorder characterized by high blood levels of potassium that may cause kidney failure. A 53-year-old man with AIDS suddenly developed hyperkalemia after being treated with trimethoprim, sulfamethoxazole and prednisone for Pneumocystis carinii pneumonia. His blood levels of potassium increased after several weeks of treatment, and his urinary levels of potassium decreased. Trimethoprim and sulfamethoxazole may interfere with the excretion of potassium by the kidneys. A research study found that trimethoprim may also interfere with sodium movement across the membranes of kidney cells. Low doses of trimethoprim usually do not cause hyperkalemia, and AIDS patients are also frequently suffering from impaired kidney function.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1993
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A mechanism for pentamidine-induced hyperkalemia: inhibition of distal nephron sodium transport
Article Abstract:
Pentamidine appears to cause hyperkalemia by inhibiting sodium transport in the kidneys. Hyperkalemia is an excess of potassium in the blood. Pentamidine is an antiparasitic drug used to treat Pneumocystis carinii pneumonia, a common complication of AIDS. Administration of pentamidine for more than six days is associated with hyperkalemia in up to 100% of AIDS patients. Researchers tested the effects of pentamidine on active biological transport in the kidneys using two laboratory models. They found that pentamidine blocked sodium channels. Diminished sodium transport is associated with impaired potassium excretion, which leads to hyperkalemia. Further experiments indicated that the pentamidine-induced inhibition of sodium channel activity is reversible.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1995
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Managing hyperkalemia caused by inhibitors of the renin-angiotensin-aldosterone system
Article Abstract:
Hyperkalemia in likely to become an even more common clinical event, since angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers are increasingly being used in higher doses and in combination, in the belief that these measures provide additional cardiovascular protection. In patients receiving some combination of an ACE inhibitor, an angiotensin-receptor blocker, and an aldosterone-receptor blocker, discontinuation of one drug may also be effective in lowering the serum potassium concentration.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2004
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