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Indomethacin-induced azotaemia and hyperkalaemia: a case study.

Abstract
We present a patient in whom indomethacin treatment for acute gouty arthritis induced reversible azotaemia and hyperkalaemia. Re-introduction of the drug under controlled conditions of metabolic balance resulted in recurrence of hyperkalaemia and azotaemia, and was associated with a fall in plasma renin activity, but no change was observed in plasma aldosterone. Since potassium retention and hyperkalaemia occurred in the absence of hypoaldosteronism, other factors must be invoked to explain the observed upset in potassium homeostasis. This, and other recent case reports suggest that prostaglandin synthetase inhibitors such as indomethacin should be used with caution, especially in patients with pre-existing azotaemia, congestive heart failure, or gout.
AuthorsM G Nicholls, E A Espiner
JournalThe New Zealand medical journal (N Z Med J) Vol. 94 Issue 696 Pg. 377-9 (Nov 25 1981) ISSN: 0028-8446 [Print] New Zealand
PMID7033849 (Publication Type: Case Reports, Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Sodium
  • Renin
  • Potassium
  • Indomethacin
Topics
  • Acute Disease
  • Aged
  • Clinical Trials as Topic
  • Female
  • Gout (drug therapy)
  • Humans
  • Hyperkalemia (chemically induced, metabolism)
  • Indomethacin (adverse effects)
  • Potassium (metabolism)
  • Renin (blood)
  • Sodium (metabolism)
  • Uremia (chemically induced)

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