Hyperkalemia Associated with Angiotensin Converting Enzyme Inhibitor or Angiotensin Receptor Blockers in Chronic Kidney Disease
Inhibition of the renin-angiotensin-aldosterone system (RAAS) is a key strategy in treating hypertension in cardiovascular and renal diseases. However, RAAS inhibitors (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, aldosterone receptor antagonists, and direct renin inhibit...
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Interna Publishing
2020-04-01
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| Series: | Acta Medica Indonesiana |
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| Online Access: | https://www.actamedindones.org/index.php/ijim/article/view/1022 |
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| author | Yudi Her Oktaviono Novia Kusumawardhani |
| author_facet | Yudi Her Oktaviono Novia Kusumawardhani |
| author_sort | Yudi Her Oktaviono |
| collection | DOAJ |
| description | Inhibition of the renin-angiotensin-aldosterone system (RAAS) is a key strategy in treating hypertension in cardiovascular and renal diseases. However, RAAS inhibitors (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, aldosterone receptor antagonists, and direct renin inhibitors) increase the risk of hyperkalemia (serum potassium >5.5 mmol/L). This poses a therapeutic challenge because these patient groups comprise in whom the drugs are therapeutically indicated. Important considerations when initiating ACEI or ARB therapy include obtaining an estimate of glomerular filtration rate and a baseline serum potassium concentration, as well as assessing whether the patient has excessive potassium intake from diet, supplements, or drugs that can also increase serum potassium. Serum potassium monitoring shortly after initiation of therapy can assist in preventing hyperkalemia. If hyperkalemia does develop, prompt recognition of cardiac dysrhythmias and effective treatment to antagonize the cardiac effects of potassium, redistribute potassium into cells, and remove excess potassium from the body is important. Understanding the mechanism of action and monitoring of ACEI and ARB coupled with judicious drug use and clinical vigilance can minimize the risk to the patient of developing hyperkalemia. |
| format | Article |
| id | doaj-art-1fa0051835ec400b970052b6bfff3c0e |
| institution | DOAJ |
| issn | 0125-9326 2338-2732 |
| language | English |
| publishDate | 2020-04-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | Acta Medica Indonesiana |
| spelling | doaj-art-1fa0051835ec400b970052b6bfff3c0e2025-08-20T02:50:17ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322020-04-01521Hyperkalemia Associated with Angiotensin Converting Enzyme Inhibitor or Angiotensin Receptor Blockers in Chronic Kidney DiseaseYudi Her Oktaviono0Novia Kusumawardhani1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University, Surabaya, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University, Surabaya, IndonesiaInhibition of the renin-angiotensin-aldosterone system (RAAS) is a key strategy in treating hypertension in cardiovascular and renal diseases. However, RAAS inhibitors (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, aldosterone receptor antagonists, and direct renin inhibitors) increase the risk of hyperkalemia (serum potassium >5.5 mmol/L). This poses a therapeutic challenge because these patient groups comprise in whom the drugs are therapeutically indicated. Important considerations when initiating ACEI or ARB therapy include obtaining an estimate of glomerular filtration rate and a baseline serum potassium concentration, as well as assessing whether the patient has excessive potassium intake from diet, supplements, or drugs that can also increase serum potassium. Serum potassium monitoring shortly after initiation of therapy can assist in preventing hyperkalemia. If hyperkalemia does develop, prompt recognition of cardiac dysrhythmias and effective treatment to antagonize the cardiac effects of potassium, redistribute potassium into cells, and remove excess potassium from the body is important. Understanding the mechanism of action and monitoring of ACEI and ARB coupled with judicious drug use and clinical vigilance can minimize the risk to the patient of developing hyperkalemia.https://www.actamedindones.org/index.php/ijim/article/view/1022hyperkalemiaangiotensin converting enzyme inhibitorangiotensin receptor blockerchronic kidney disesase |
| spellingShingle | Yudi Her Oktaviono Novia Kusumawardhani Hyperkalemia Associated with Angiotensin Converting Enzyme Inhibitor or Angiotensin Receptor Blockers in Chronic Kidney Disease Acta Medica Indonesiana hyperkalemia angiotensin converting enzyme inhibitor angiotensin receptor blocker chronic kidney disesase |
| title | Hyperkalemia Associated with Angiotensin Converting Enzyme Inhibitor or Angiotensin Receptor Blockers in Chronic Kidney Disease |
| title_full | Hyperkalemia Associated with Angiotensin Converting Enzyme Inhibitor or Angiotensin Receptor Blockers in Chronic Kidney Disease |
| title_fullStr | Hyperkalemia Associated with Angiotensin Converting Enzyme Inhibitor or Angiotensin Receptor Blockers in Chronic Kidney Disease |
| title_full_unstemmed | Hyperkalemia Associated with Angiotensin Converting Enzyme Inhibitor or Angiotensin Receptor Blockers in Chronic Kidney Disease |
| title_short | Hyperkalemia Associated with Angiotensin Converting Enzyme Inhibitor or Angiotensin Receptor Blockers in Chronic Kidney Disease |
| title_sort | hyperkalemia associated with angiotensin converting enzyme inhibitor or angiotensin receptor blockers in chronic kidney disease |
| topic | hyperkalemia angiotensin converting enzyme inhibitor angiotensin receptor blocker chronic kidney disesase |
| url | https://www.actamedindones.org/index.php/ijim/article/view/1022 |
| work_keys_str_mv | AT yudiheroktaviono hyperkalemiaassociatedwithangiotensinconvertingenzymeinhibitororangiotensinreceptorblockersinchronickidneydisease AT noviakusumawardhani hyperkalemiaassociatedwithangiotensinconvertingenzymeinhibitororangiotensinreceptorblockersinchronickidneydisease |