Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause a number of adverse renal effects. Hyperkalemia is one of the most common electrolyte disorders associated with NSAID therapy. NSAIDs reduce endogenous prostaglandin-E synthesis, which stimulates renin and subsequent aldosterone synthesis. Aldosterone significantly increases renal potassium excretion and is the primary regulatory hormone produced for this purpose. Thus, NSAIDs induce a state of hyporeninemic hypoaldosteronism and precipitate hyperkalemia through a reduction in renal potassium excretion.
- Induction of hyporeninemic hypoaldosteronism.
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