Hypokalaemia Potentially Linked to Meropenem Therapy in a Patient with End-Stage Renal Disease

Abstract

Hypokalemia is a frequently encountered electrolyte abnormality in hospitalized patients and is most often linked to recognizable factors such as gastrointestinal losses, diuretic therapy, or shifts of potassium into cells. In contrast, hypokalemia related to drug therapy is reported less often, and its association with meropenem remains uncommon and may be easily overlooked in clinical practice. A 60-year-old woman with a history of diabetes, hypertension, and chronic kidney disease was admitted with a diagnosis of urosepsis and fluid overload. Her initial potassium levels were within the normal range. She was treated with intravenous meropenem as part of the sepsis treatment. After a few days of therapy, her potassium levels unexpectedly and gradually decreased, leading to significant hypokalaemia. No other identifiable cause of potassium loss was found during the evaluation, suggesting that meropenem likely caused hypokalaemia. Although Meropenem is generally considered a safe antibiotic, few reports have described its association with hypokalaemia following discontinuation of meropenem, serum potassium levels gradually improved with supportive management. This case report highlights the importance of regular electrolyte monitoring in patients receiving meropenem, especially those with underlying comorbidities or at increased risk of electrolyte imbalance. Categories: Internal Medicine, Nephrology, Infectious Disease.