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Hyponatraemia associated with trimethoprim use.

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Area of Science:

  • Nephrology
  • Clinical Pharmacology

Background:

  • Trimethoprim (TMP) is a widely used antibiotic.
  • While generally safe, TMP can rarely cause electrolyte disturbances.

Observation:

  • Three patients presented with symptomatic hyponatraemia requiring hospitalization during TMP treatment.
  • One patient also experienced hyperkalaemia and type 4 renal tubular acidosis.

Findings:

  • TMP-induced electrolyte and acid-base disorders resolved after drug discontinuation.
  • TMP may inhibit sodium influx via the epithelial sodium channel in the cortical collecting duct, affecting sodium and potassium balance.

Implications:

  • This study highlights a rare but significant adverse effect of TMP.
  • Clinicians should consider evaluating electrolytes in patients experiencing clinical changes after starting TMP.