skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8830

A comparative study of the prevalence of hyperkalemia with the use of angiotensin-converting enzyme inhibitors versus angiotensin receptor blockers

Original Research

(3002) Views  (1078) Full article downloads

Authors: Seyed Ali Sadjadi, James I McMillan, Navin Jaipaul, Patricia Blakely, et al.

Published Date July 2009 Volume 2009:5 Pages 547 - 552
DOI: http://dx.doi.org/10.2147/TCRM.S5176

Seyed Ali Sadjadi1, James I McMillan1, Navin Jaipaul1, Patricia Blakely1, Su Su Hline2

1Section of Nephrology (111N), Jerry L Pettis Memorial Veterans Medical Center, Loma Linda, CA, USA; 2Divison of Nephrology, Loma Linda University Medical Center, Loma Linda, CA, USA

Background and objectives: Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are increasingly used in a variety of settings including heart failure, renal failure, arterial hypertension, and diabetic nephropathy. The objective of this study was to investigate the prevalence of hyperkalemia with ACEI and ARB use, in a population of the United States veterans.

Design, settings, material, and measurements: Retrospective observational cohort study of 1163 patients on ACEIs and 1168 patients on ARBs in a single Veterans Affairs Medical Center. Electronic medical records were reviewed over a 12-month period with data collected on various demographic, laboratory, comorbidity, and medication related variables.

Results: Hyperkalemia (>5 mEq/L) was observed in 20.4% of patients on ACEIs and 31.0% on ARBs. Severe hyperkalemia (6 mEq/L or higher), was observed in 0.8% of ACEI and 2.8% of ARB users. In univariate logistic regression analyses, diabetes mellitus; serum glucose, total carbon dioxide content, creatinine, and estimated glomerular filtration rate (GFR) were significantly associated with hyperkalemia. ARB use, when compared to ACEI, was associated with a 42% increase in odds of hyperkalemia (odds ratio [OR] = 1.42; p = 0.001) in a model including adjustment for GFR and a 56% increase in odds of hyperkalemia (OR = 1.56; p < 0.001) in a model including adjustment for serum creatinine.

Conclusions: Hyperkalemia, associated with the use of ACEIs and ARBs, is usually mild and severe hyperkalemia is rare. Hyperkalemia is more common with ARBs than ACEIs. ARB use, when compared to ACEI use, may significantly and independently be associated with increased odds of hyperkalemia.

Keywords: hyperkalemia, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers








Readers of this article also read:

Angiotensin receptor blockers for the reduction of proteinuria in diabetic patients with overt nephropathy: results from the AMADEO study
Venous and arterial thrombosis: Two aspects of the same disease?
Role of aliskiren in cardio-renal protection and use in hypertensives with multiple risk factors
Safety and efficacy of telbivudine for the treatment of chronic hepatitis B
Artemether–lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria
Lasofoxifene for the prevention and treatment of postmenopausal osteoporosis
Retinal nerve fiber layer thickness in recovered and persistent amblyopia
Improvement of adenoviral vector-mediated gene transfer to airway epithelia by folate-modified anionic liposomes
Antioxidant oils and Salmonella enterica Typhimurium reduce tumor in an experimental model of hepatic metastasis
Cumulative clinical experience from over a decade of use of levofloxacin in community-acquired pneumonia: critical appraisal and role in therapy