Metabolic acidosis. Development in two patients receiving a potassium-sparing diuretic and total parenteral nutrition

Two patients developed a metabolic acidosis associated with a normal undetermined anion concentration while receiving a potassium-sparing diuretic and total parenteral nutrition. In both cases the metabolic acidosis resolved within one week after discontinuing administration of the diuretic. The use of potassium-sparing diuretics in a patient receiving total parenteral nutrition requires caution and continued monitoring for this potential drug-nutrient interaction.