Onset of Hyperkalemia following the Administration of Angiotensin-Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker
Introduction. In spite of the established importance of detecting angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker- (ARB-) induced hyperkalemia, there have not been many studies on the time of its occurrence. Methods. We retrospectively analyzed electronic medical re...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Cardiovascular Therapeutics |
| Online Access: | http://dx.doi.org/10.1155/2021/5935149 |
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| author | Hye-Ran Jun Hyunah Kim Seung-Hwan Lee Jae Hyoung Cho Hyunyong Lee Hyeon Woo Yim Kun-Ho Yoon Hun-Sung Kim |
| author_facet | Hye-Ran Jun Hyunah Kim Seung-Hwan Lee Jae Hyoung Cho Hyunyong Lee Hyeon Woo Yim Kun-Ho Yoon Hun-Sung Kim |
| author_sort | Hye-Ran Jun |
| collection | DOAJ |
| description | Introduction. In spite of the established importance of detecting angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker- (ARB-) induced hyperkalemia, there have not been many studies on the time of its occurrence. Methods. We retrospectively analyzed electronic medical records to determine the onset time and incidence rate of hyperkalemia (serum potassium>5.5 mEq/L or 6.0 mEq/L) among hospitalized patients newly started on a 15-day ACEI or ARB therapy. Results. Among 3101 hospitalized patients, hyperkalemia incidence was 0.5%–0.9% and 0.8%–2.1% in the ACEI and ARB groups, respectively. However, it was not significantly different among different ARB types. Hyperkalemia’s onset was distributed throughout 15 days, without any trend. Hyperkalemia incidence was 7.3 and 35.1 times higher at 5.5 mEq/L (hazard ratio HR=7.31, 95%confidence interval CI=4.19–12.76, p<0.001) and 6.0 mEq/L (HR=35.11, 95%CI=8.25–149.52, p<0.001), respectively, than the baseline creatinine level. Hyperkalemia incidence in patients with chronic renal failure was 5.7 and 9.2 times higher at 5.5 mEq/L (HR=5.72, 95%CI=3.24–10.12, p<0.001) and 6.0 mEq/L (HR=9.16, 95%CI=4.02–20.88, p<0.001), respectively. Conclusions. It is unlikely that it is necessary to monitor hyperkalemia immediately after administration of ACEI or ARB. However, when prescribed for patients with abnormal kidney function, clinicians should always consider the possibility of developing hyperkalemia. |
| format | Article |
| id | doaj-art-55efaa03a9ea45ad84dc59a7709d67b2 |
| institution | OA Journals |
| issn | 1755-5914 1755-5922 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
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| series | Cardiovascular Therapeutics |
| spelling | doaj-art-55efaa03a9ea45ad84dc59a7709d67b22025-08-20T02:04:55ZengWileyCardiovascular Therapeutics1755-59141755-59222021-01-01202110.1155/2021/59351495935149Onset of Hyperkalemia following the Administration of Angiotensin-Converting Enzyme Inhibitor or Angiotensin II Receptor BlockerHye-Ran Jun0Hyunah Kim1Seung-Hwan Lee2Jae Hyoung Cho3Hyunyong Lee4Hyeon Woo Yim5Kun-Ho Yoon6Hun-Sung Kim7Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaCollege of Pharmacy, Sookmyung Women’s University, Seoul, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaClinical Research Coordinating Center, Catholic Medical Center, The Catholic University of Korea, Republic of KoreaDepartment of Preventive Medicine, College of Medicine, The Catholic University of Korea, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaIntroduction. In spite of the established importance of detecting angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker- (ARB-) induced hyperkalemia, there have not been many studies on the time of its occurrence. Methods. We retrospectively analyzed electronic medical records to determine the onset time and incidence rate of hyperkalemia (serum potassium>5.5 mEq/L or 6.0 mEq/L) among hospitalized patients newly started on a 15-day ACEI or ARB therapy. Results. Among 3101 hospitalized patients, hyperkalemia incidence was 0.5%–0.9% and 0.8%–2.1% in the ACEI and ARB groups, respectively. However, it was not significantly different among different ARB types. Hyperkalemia’s onset was distributed throughout 15 days, without any trend. Hyperkalemia incidence was 7.3 and 35.1 times higher at 5.5 mEq/L (hazard ratio HR=7.31, 95%confidence interval CI=4.19–12.76, p<0.001) and 6.0 mEq/L (HR=35.11, 95%CI=8.25–149.52, p<0.001), respectively, than the baseline creatinine level. Hyperkalemia incidence in patients with chronic renal failure was 5.7 and 9.2 times higher at 5.5 mEq/L (HR=5.72, 95%CI=3.24–10.12, p<0.001) and 6.0 mEq/L (HR=9.16, 95%CI=4.02–20.88, p<0.001), respectively. Conclusions. It is unlikely that it is necessary to monitor hyperkalemia immediately after administration of ACEI or ARB. However, when prescribed for patients with abnormal kidney function, clinicians should always consider the possibility of developing hyperkalemia.http://dx.doi.org/10.1155/2021/5935149 |
| spellingShingle | Hye-Ran Jun Hyunah Kim Seung-Hwan Lee Jae Hyoung Cho Hyunyong Lee Hyeon Woo Yim Kun-Ho Yoon Hun-Sung Kim Onset of Hyperkalemia following the Administration of Angiotensin-Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker Cardiovascular Therapeutics |
| title | Onset of Hyperkalemia following the Administration of Angiotensin-Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker |
| title_full | Onset of Hyperkalemia following the Administration of Angiotensin-Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker |
| title_fullStr | Onset of Hyperkalemia following the Administration of Angiotensin-Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker |
| title_full_unstemmed | Onset of Hyperkalemia following the Administration of Angiotensin-Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker |
| title_short | Onset of Hyperkalemia following the Administration of Angiotensin-Converting Enzyme Inhibitor or Angiotensin II Receptor Blocker |
| title_sort | onset of hyperkalemia following the administration of angiotensin converting enzyme inhibitor or angiotensin ii receptor blocker |
| url | http://dx.doi.org/10.1155/2021/5935149 |
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