Indomethacin-induced hyperkalemia in three patients with gouty arthritis

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Abstract
Three patients in whom severe, life-threatening hyperkalemia and renal insufficiency developed after treatment of acute gouty arthritis with indomethacin are described. This complication may result from an inhibition of prostaglandin synthesis and consequent hyporeninemic hypoaldosteronism. Careful attention to renal function and K balance in patients receiving indomethacin or other nonsteroidal anti-inflammatory agents, particularly in those patients with diabetes mellitus or preexisting renal disease, will help prevent this potentially serious complication.