Severe Electrolyte Disturbances Complicated by Seizures and Acute Kidney Injury Within 10 Days of Starting Indapamide

Abstract

Indapamide is one of the most effective and well-known anti-hypertensive medications. Electrolyte disturbances have been classically recognized as a typical side effect profile of indapamide. The most common electrolyte imbalance described with indapamide was hypokalemia; however, hyponatremia is being increasingly reported. In this case, we report a unique form of severe electrolytes derangement (hyponatremia, hypokalemia, hypophosphatemia, and hypocalcemia), which was complicated by seizures, rhabdomyolysis, and acute kidney injury that occurred within only 10 days of indapamide initiation. The patient was admitted to the medical intensive care unit for prompt electrolyte replacement and close monitoring. With the discontinuation of indapamide and the prompt replacement of the deficient electrolytes, the patient's condition has improved dramatically, and he was discharged in a good state of health. Electrolyte disturbances are expected to be seen with indapamide usage, and it might be associated with severe consequences like arrhythmias and seizures. This case report would raise awareness and add to the importance of closely following patients after prescribing indapamide.