A case of hypokalemia-induced fatal arrhythmia caused by indapamide in an anorexic elderly patient - PubMed

Affiliations

• PMID: 21671161
• DOI: 10.1007/s10157-011-0474-5

Case Reports

A case of hypokalemia-induced fatal arrhythmia caused by indapamide in an anorexic elderly patient

Naro Ohashi et al. Clin Exp Nephrol. 2011 Oct.

Abstract

An 84-year-old man was referred to our hospital for atrioventricular block and severe hypokalemia. He had been treated for hypertension since 2007 with indapamide, a thiazide-like diuretic. His laboratory data had not been tested for a long time. One week before his first visit, he suffered from a common cold and anorexia. He was admitted to our hospital because his electrocardiogram showed ventricular flutter, and pulmonary arrest occurred at the time of his visit. Cardiopulmonary resuscitation was successfully performed. Hypokalemia (K, 1.7 mEq/L) was considered as the cause of acute cardiopulmonary failure. His oral intake of potassium decreased, but potassium loss from the kidney persisted (urinary potassium, 14.0 mEq/L; transtubular potassium gradient, 5.00). These results suggested that although hypokalemia was suspected to have been present for a long time due to indapamide, severe hypokalemia was induced during the period of anorexia. After discontinuation of indapamide and intravenous administration of potassium L: -aspartate for potassium supplementation, the patient's serum potassium levels increased and his general condition improved. Although it is well known that hypokalemia is caused by indapamide, the incidence is not frequent and if observed is not severe. However, we experienced an unusual case of hypokalemia-induced fatal arrhythmia caused by indapamide. Hence, the serum potassium concentration of patients under the drug, especially anorexic elderly patients, should be monitored.

Similar articles

• [Intraoperative management of potentially fatal arrhythmias after anesthesia induced by severe hypokalemia: A case report].

  Wang JC, Yao YX, Guo XY. Wang JC, et al. Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Feb 18;55(1):186-189. doi: 10.19723/j.issn.1671-167X.2023.01.029. Beijing Da Xue Xue Bao Yi Xue Ban. 2023. PMID: 36718710 Free PMC article. Chinese.

• [Severe ventricular arrhythmia secondary to indapamide-induced hypopotassemia].

  Guzzini F, Baroffio R, Coppetti D, Gasparini P. Guzzini F, et al. Clin Ter. 1990 Nov 30;135(4):283-7. Clin Ter. 1990. PMID: 1705875 Italian.

• Indapamide-induced severe hyponatremia and hypokalemia.

  Chan TY. Chan TY. Ann Pharmacother. 1995 Nov;29(11):1124-8. doi: 10.1177/106002809502901111. Ann Pharmacother. 1995. PMID: 8573958

• [Hyponatremia with somnolence due to indapamide].

  Hamano T, Yamamoto T, Miyamori I, Kuriyama M. Hamano T, et al. Rinsho Shinkeigaku. 2008 Jan;48(1):52-5. doi: 10.5692/clinicalneurol.48.52. Rinsho Shinkeigaku. 2008. PMID: 18386633 Review. Japanese.

• Comparison of thiazide-like diuretics versus thiazide-type diuretics: a meta-analysis.

  Liang W, Ma H, Cao L, Yan W, Yang J. Liang W, et al. J Cell Mol Med. 2017 Nov;21(11):2634-2642. doi: 10.1111/jcmm.13205. Epub 2017 Jun 19. J Cell Mol Med. 2017. PMID: 28631393 Free PMC article. Review.

Cited by

• Interstitial Nephritis Caused by Anorexia Nervosa in Young Male; A Case Report and Literature Review.

  Choi JW, Kwon SK, Kim SM, Cho H, Lee HC, Kim HY. Choi JW, et al. Electrolyte Blood Press. 2018 Jun;16(1):15-17. doi: 10.5049/EBP.2018.16.1.15. Epub 2018 Jun 30. Electrolyte Blood Press. 2018. PMID: 30046330 Free PMC article.

• [Intraoperative management of potentially fatal arrhythmias after anesthesia induced by severe hypokalemia: A case report].

  Wang JC, Yao YX, Guo XY. Wang JC, et al. Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Feb 18;55(1):186-189. doi: 10.19723/j.issn.1671-167X.2023.01.029. Beijing Da Xue Xue Bao Yi Xue Ban. 2023. PMID: 36718710 Free PMC article. Chinese.

References

Publication types

MeSH terms

Substances

LinkOut - more resources

• Full Text Sources

  • Springer

• Medical

  • MedlinePlus Health Information