Incidence of risk factors for developing hyperkalemia when using ACE inhibitors in cardiovascular diseases

Amir, Omalhassan; Sarriff, Azmi; Awaisu, Ahmed; Aziz, Noorizan Abd; Ismail, Omar

doi:10.1007/s11096-009-9288-x

Cited by 27 publications

(16 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Data from other observational studies regarding correlations between smoking and hyperkalemia are limited. In a prospective cohort study of 500 patients with various cardiovascular diseases but no CKD, previous smoking history posed a protective role in hyperkalemia development [24] . However, in a cross-sectional study including 1,227 CKD patients smoking did not correlate significantly with serum potassium levels [25] .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Hyperkalemia in Diabetic and Non-Diabetic Patients with Chronic Kidney Disease: A Nested Case-Control Study

Loutradis

Tolika²,

Σκόδρα³

et al. 2015

Am J Nephrol

View full text Add to dashboard Cite

Background: Hyperkalemia is a potentially life-threatening disorder, usually complicating chronic kidney disease (CKD). Factors superimposed to reduced renal function are further elevating hyperkalemia risk, but their contribution is not fully elucidated. This study aimed to compare the prevalence of hyperkalemia in diabetic and non-diabetic patients with CKD. Methods: This is a nested case-control study of 180 type-2 diabetic and 180 non-diabetic patients with CKD followed in a Nephrology outpatient clinic, matched for gender, age and estimated glomerular filtration rate. Type-1 diabetes or end-stage renal disease patients were excluded. Prevalence of hyperkalemia was defined as potassium >5 mEq/l or use of sodium polystyrene sulfonate, and further by potassium >5, ≥5.2 and ≥5.5 mEq/l. It was calculated in both groups in whole and CKD stages separately. Univariate and multivariate logistic regression analysis were conducted to identify factors associated with hyperkalemia. Results: The prevalence of hyperkalemia was higher in diabetic CKD patients (27.2 vs. 20%, p = 0.107) and remained around 30% higher with all secondary definitions used, but never reached statistical significance. In Stage 2, no difference was noted (8.7 vs. 17.4%, p = 0.665); in Stage 3, it was significantly higher in diabetics (28.6 vs. 17.5%, p = 0.036); and in Stage 4, it was equally high in both groups (35.5 vs. 32.3%, p = 0.788). In multivariate analysis, Stage 4 CKD (OR 4.535, 95% CI 1.561-13.173), use of angiotensin-converting enzyme inhibitors (ACEIs; OR 2.228, 95% CI 1.254-3.958) and smoking (OR 2.254, 95% CI 1.218-4.171) were independently associated with hyperkalemia. Conclusions: Diabetes mellitus was found to elevate the prevalence of hyperkalemia only in CKD Stage 3 patients (moderately impaired renal function). Advanced CKD at Stage 4 and ACEIs are major determinants of hyperkalemia occurrence.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence of Hyperkalemia in Diabetic and Non-Diabetic Patients with Chronic Kidney Disease: A Nested Case-Control Study

Loutradis

Tolika²,

Σκόδρα³

et al. 2015

Am J Nephrol

View full text Add to dashboard Cite

show abstract

“…In patients with hypertensive chronic kidney disease treated with ACE inhibitors, hyperkalemia occurs frequently if the baseline and follow-up GFR is lower than 40 mL/min/1.73 m 2 [22]. Renal disease is identified as one of the predictors of hyperkalemia secondary to ACE inhibitor drug interaction [23]. In addition, Maddirala et al [24] reported that the incidence of hyperkalemia increased with progression of the stage of chronic kidney disease in ACE inhibitor or ARB users.…”

Section: Resultsmentioning

confidence: 99%

The Significance of Angiotensin Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker Use in Sudden Cardiac Death

Onodera¹,

Kikuchi²,

Fujino³

et al. 2017

IJCM

View full text Add to dashboard Cite

Objectives: To investigate the relationship between the use of angiotensin converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) and hyperkalemia in patients diagnosed with sudden cardiac death. Methods: We examined oral ACE inhibitor or ARB use among cardiopulmonary arrest patients brought by ambulance to our emergency room during a 5-year period from January 2012 to December 2016. The cause of death was determined to be sudden cardiac death, despite temporary return of spontaneous circulation after starting cardiopulmonary resuscitation. Subjects were dichotomized into 2 groups, those taking and those not taking an ACE inhibitor or ARB. Variables determined retrospectively included serum potassium, estimated glomerular filtration rate as an index of kidney function and time from cardiopulmonary arrest to return of spontaneous circulation. The Mann-Whitney U-test was used to compare continuous data, and the chi-square test to compare categorical data between groups. The results are expressed as the median plus range. Statistical significance was assumed at p < 0.05. Results: Thirtyfive patients met the inclusion criteria. The mean age was 77.1 years (range, 35 -93 years), and there were 26 males and 9 females. Eleven subjects were ACE inhibitor or ARB users, and 24 were non-users. The serum potassium level was significantly higher in users than non-users (median, 6.2 mEq/L (range,

show abstract

“…Hyperkalemia and hypokalemia are both commonly seen during the management of patients with HF. The former is most commonly seen in patients on more than one of ACEi, ARB, or MRA medications, diabetes or stage 3 or higher chronic kidney disease (22,23). Hypokalemia is most often seen with combination or intravenous diuretic therapy, especially if a thiazide, such as metolazone is used as part of the regimen.…”

Section: A Note On New Therapiesmentioning

confidence: 99%

The Canadian Cardiovascular Society Heart Failure Companion: Bridging Guidelines to Your Practice

Howlett

Chan

Ezekowitz

et al. 2016

Canadian Journal of Cardiology

View full text Add to dashboard Cite

The Canadian Cardiovascular Society Heart Failure (HF) Guidelines Program has generated annual HF updates, including formal recommendations and supporting Practical Tips since 2006. Many clinicians indicate they routinely use the Canadian Cardiovascular Society HF Guidelines in their daily practice. However, many questions surrounding the actual implementation of the Guidelines into their daily practice remain. A consensus-based approach was used, including feedback from the Primary and Secondary HF Panels. This companion is intended to answer several key questions brought forth by HF practitioners such as appropriate timelines for initial assessments and subsequent reassessments of patients, the order in which medications should be added, how newer medications should be included in treatment algorithms, and when left ventricular function should be reassessed. A new treatment algorithm for HF with reduced ejection fraction is included. Several other practical issues are addressed such as an approach to management of hyperkalemia/hypokalemia, treatment of gout, when medications can be stopped, and whether a target blood pressure or heart rate is suggested. Finally, elements and teaching of self-care are described. This tool will hopefully function to allow better integration of the HF Guidelines into clinical practice.

show abstract

Incidence of risk factors for developing hyperkalemia when using ACE inhibitors in cardiovascular diseases

Cited by 27 publications

References 34 publications

Prevalence of Hyperkalemia in Diabetic and Non-Diabetic Patients with Chronic Kidney Disease: A Nested Case-Control Study

Prevalence of Hyperkalemia in Diabetic and Non-Diabetic Patients with Chronic Kidney Disease: A Nested Case-Control Study

The Significance of Angiotensin Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker Use in Sudden Cardiac Death

The Canadian Cardiovascular Society Heart Failure Companion: Bridging Guidelines to Your Practice

Contact Info

Product

Resources

About