• Bol Asoc Med P R · Jul 2011

    Case Reports

    Life threatening hyperkalemia chronic kidney diseases patients treated with trimethoprim-sulfamethoxazole: a case series.

    • Ricardo Calderón-Ortiz, Pedro Colton-Verge, Myrna Muñiz-Ortega, Laura Lespier, and Héctor Córdova.
    • Renal Section, Department of Medicine, Veterans Affairs Caribbean Health Care System, San Juan, Puerto Rico.
    • Bol Asoc Med P R. 2011 Jul 1; 103 (3): 15-7.

    AbstractWe report a case series of patients that develop severe life threatening hyperkalemia after use of a commonly prescribe oral antibiotic, Trimethoprim-Sulfamethoxazole. The three patients required acute hemodialysis to normalize serum potassium levels after development of hypotension and heart block due to hyperkalemia. All had preexisting chronic kidney disease. Some of them were on medications that interfere with the effects of aldosterone. Patients with chronic kidney disease, particularly those receiving other medications that may also contribute to the development of hyperkalemia, should be closely monitored for this complication when Trimethoprim-containing antibiotic is needed. In these cases, other antibiotic therapy alternatives should be considered.

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