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Heparin-induced hyperkalemia: a prospective study
G González-Martin1, M S Díaz-Molinas, A M Martínez
1Faculty of Chemistry, Department of Pharmacy, Pontifical Catholic University, Santiago, Chile.
International Journal of Clinical Pharmacology, Therapy, and Toxicology
|November 1, 1991
Summary
Heparin can cause hyperkalemia, a serious adverse effect, particularly in patients with diabetes or those on long-term therapy. This drug monitoring study highlights the importance of vigilance for this uncommon complication.
Area of Science:
- Pharmacology
- Internal Medicine
- Clinical Pharmacy
Background:
- Heparin is a common anticoagulant for deep venous thromboembolism prophylaxis and treatment.
- Heparin can induce hypoaldosteronism, potentially leading to hyperkalemia, an uncommon adverse effect.
- Understanding the incidence and risk factors for heparin-induced hyperkalemia is crucial for patient safety.
Purpose of the Study:
- To prospectively monitor adverse drug reactions in patients receiving heparin.
- To determine the frequency and characteristics of heparin-induced hyperkalemia.
- To identify patient factors associated with the development of hyperkalemia.
Main Methods:
- A prospective drug monitoring study was conducted on 154 inpatients receiving heparin.
- Data collected included patient demographics, heparin dosage, and adverse events.
- Adverse events were systematically recorded and classified by a monitoring team and physicians.
Main Results:
- Thirteen cases of hyperkalemia were identified among 154 patients (13.6% incidence).
- Eight patients experienced severe hyperkalemia; no fatal reactions occurred.
- Hyperkalemia was dose-related and more frequent in patients with diabetes mellitus, metabolic acidosis, and those on long-term heparin therapy.
Conclusions:
- Heparin-induced hyperkalemia is an uncommon but potentially severe adverse effect.
- Risk factors include diabetes mellitus, metabolic acidosis, and prolonged heparin administration.
- Close monitoring for hyperkalemia is recommended in patients receiving heparin, especially those with identified risk factors.