Which of the following metabolic abnormality is seen with long term use of spironolactone?: (A) Metabolic acidosis, (B) Metabolic alkalosis, (C) Hyperkalemia, (D) None of the above
Answer is A. By inhibiting H+ secretion in parallel with K+ secretion, the K+-sparing diuretics can cause acidosis similar to that seen with type IV renal tubular acidosis. Ref: Katzung, 11th edition, Chapter 15.