Document Detail


Control of hyperkalemia with fludrocortisone in a patient with systemic lupus erythematosus.
MedLine Citation:
PMID:  2350905     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We describe the use of fludrocortisone in a patient with systemic lupus erythematosus, who initially presented with moderate renal insufficiency, high serum potassium, metabolic acidosis, low urine pH, and a high urinary anion gap indicating tubular dysfunction. Renal histology revealed membranous glomerulonephritis and interstitial inflammation. During the course of the disease the patient developed persistent severe hyperkalemia. Dietary potassium restriction and therapy with diuretics combined with cation exchange resins failed to decrease potassium levels sufficiently. Drug therapy including cyclosporin A, enalapril, atenolol, phenytoin, necessary to control active disease and severe hypertension contributed to elevated potassium levels. Effective correction of hyperkalemia was achieved by fludrocortisone treatment. We conclude that fludrocortisone is a potent therapeutic approach for selected patients suffering from life threatening hyperkalemia, in whom potassium elevating drugs cannot be withdrawn.
Authors:
K W Dreyling; C Wanner; P Schollmeyer
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  33     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  1990 Apr 
Date Detail:
Created Date:  1990-07-19     Completed Date:  1990-07-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  GERMANY, WEST    
Other Details:
Languages:  eng     Pagination:  179-83     Citation Subset:  IM    
Affiliation:
Department of Medicine, University Hospital of Freiburg, FRG.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Atenolol / adverse effects
Creatinine / urine
Cyclosporins / adverse effects
Enalapril / adverse effects
Fludrocortisone / metabolism,  therapeutic use*
Humans
Hyperkalemia / chemically induced,  drug therapy*
Kidney / drug effects,  pathology
Lupus Erythematosus, Systemic / complications*,  drug therapy
Male
Phenytoin / adverse effects
Potassium / metabolism
Renin-Angiotensin System / drug effects
Chemical
Reg. No./Substance:
0/Cyclosporins; 127-31-1/Fludrocortisone; 29122-68-7/Atenolol; 57-41-0/Phenytoin; 60-27-5/Creatinine; 7440-09-7/Potassium; 75847-73-3/Enalapril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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