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Life threatening hyperkalaemia with diarrhoea during ACE inhibition
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  • Published on:
    Authors' reply
    • Chris Isles, Renal Unit, Dumfries and Galloway Royal Infirmary, Dumfries, UK
    • Other Contributors:
      • Sue Robertson

    Dear Editor,

    We are grateful to Dr. Exton for allowing us to expand on the case we reported recently [1]. Our patient’s past history of widespread vascular disease included previous MI, CABG and heart failure which is why her therapy included enalapril 5 mg b.d., Bumetanide 2 mg od, and Bisoporolol 5 mg od. We were not unduly alarmed therefore to find that her urea had been elevated at 15.3 mmol/l with serum...

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    Conflict of Interest:
    None declared.
  • Published on:
    Diuretic induced renal failure

    Dear Editor,

    Clearly the ACE inhibitor in this case is significant in light of this lady's acute (presumably mixed "pre-renal" and "renal") renal failure. However, this was not due solely to one drug and I suspect that her illness highlights a more significant problem i.e. that of the widespread use of loop diuretics and the balance between fluid offload and renal function. Although the precise nature of her vasc...

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    Conflict of Interest:
    None declared.