Korean J Nephrol.  2002 Sep;21(5):847-854.

A Case of Severe Hypokalemia Induced by Chronic Furosemide Abuse

• Lee YS
• Lee YH
• Kim YJ
• Kwon JM
• Kim SN
• Kang DH
• Park SH
• Choi KB
• Yoon KI
• Sung SH

Abstract

A 46-year-old woman was admitted to emergency room for muscle weakness and repiratory difficulty. She was taking furosemide (4 tablets per day : 160 mg/day) without physician's prescription. Her blood pressure was 90/50 mmHg and her heart rate 74/ min. Her laboratory finding showed a low serum potassium concentration (0.9 mmol/L), CK 368 IU/L, creatine 1.6 mg/dL. The result was rechecked and confirmed. Electrocardiography showed a dip in the ST segment, prolonged QTc, 1st degree AV block and 2 : 1 AV block. Echocardiography was normal. Abdominal CT scan show right lower pole calyceal stones without nephrocalcinosis. Treatment was initiated consisting of intravenous potassium chloride. Hypokalemia was overcome in 3 days. Kidney biopsy showed hypokalemic nephropathy - interstitial nephrosis, vacuolar change of tubule, proliferation of juxtaglomerular apparatus. Paralytic ileus, rebound pleural effusion, glucose intolerance, elevation of CK were associated findings. After correction of hypokalemia, her symptoms and electrocardiographic findings returned to normal.

Keyword

Hypokalemia; 2 : 1 AV block

MeSH Terms

Atrioventricular Block
Biopsy
Blood Pressure
Creatine
Echocardiography
Electrocardiography
Emergency Service, Hospital
Female
Furosemide*
Glucose Intolerance
Heart Rate
Humans
Hypokalemia*
Intestinal Pseudo-Obstruction
Juxtaglomerular Apparatus
Kidney
Middle Aged
Muscle Weakness
Nephrocalcinosis
Nephrosis
Pleural Effusion
Potassium
Potassium Chloride
Prescriptions
Tablets
Tomography, X-Ray Computed
Creatine
Furosemide
Potassium
Potassium Chloride
Tablets