TRIMETHOPRIM-INDUCED HYPERKALEMIA IN A PATIENT WITH AIDS

Hyperkalemia has been reported in 16 to 21 percent of patients hospitalized with the acquired immunodeficiency syndrome (AIDS)1–3. Although renal failure often accompanies hyperkalemia,1,2 AIDS is associated with other abnormalities that impair renal excretion of potassium, such as adrenal insufficiency and hypoaldosteronism3–7. Adrenal insufficiency and hypoaldosteronism, however, are rare in patients with AIDS4,5. Hyperkalemia develops in 20 to 53 percent of patients with AIDS while they are receiving high doses of trimethoprim in combination with sulfamethoxazole or dapsone for the treatment of Pneumocystis carinii pneumonia8. We recently encountered a patient with AIDS… © 1993, Massachusetts Medical Society. All rights reserved.