Alappan R, Perazella MA, Buller G
Trimethoprim/sulfamethoxazole in standard dose causes hyperkalemia
Am Soc Nephrol
J Am Soc Nephrol (abstract) (Nov) 6:437 1995

High dose trimethoprim (TMP) causes hyperkalemia in AIDS patients by an amiloride-like effect on tubular K secretion. The effect of standard dose TMP/SMX on serum K was studied in 80 non-AIDS patients compared with 25 controls. A 1.2 mmol/L increase in K was noted with TMP/SMX therapy, with 21% having serum K levels greater than 5.5 mmol/L. Risk of hyperkalemia was greatest in patients with serum Cr greater than 1.2 mg/dl. Care should be taken in the use of this drug in patients with CRF. (Leehey)

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Am Soc Nephrol
Acidosis/alkalosis : Hyperkalemia
CRF by problem area : Drug use in CRF