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Renin-angiotensin system blockade is not associated with hyperkalemia in chronic hemodialysis patients

Hsin-Hung Lin1, Ya-Fei Yang, Ju-Kuang Chang

  • 1Department of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan.

Renal Failure
|December 25, 2009
PubMed

Insights

Renin-angiotensin system blockade (RASB) does not increase hyperkalemia risk in chronic hemodialysis (HD) patients. This study found RASB was associated with decreased odds for hyperkalemia, contrary to previous concerns.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Serious hyperkalemia is a risk in chronic hemodialysis (HD) patients, potentially causing arrhythmia and death.
  • Renin-angiotensin system blockade (RASB) offers cardio-protective benefits but its link to hyperkalemia in HD patients is debated.

Purpose of the Study:

  • To investigate the relationship between RASB and hyperkalemia in patients undergoing chronic hemodialysis.

Main Methods:

  • Serum potassium and clinical factors were assessed in 200 chronic HD patients.
  • Hyperkalemia was defined as serum potassium ≥ 5.3 meq/L.
  • Logistic regression analysis evaluated the risk of hyperkalemia associated with RASB and other factors.

Main Results:

  • 35% of patients had hyperkalemia; 29% were on RASB.
  • RASB was associated with significantly decreased odds for hyperkalemia (OR 0.262, p=0.001).
  • Furosemide use also showed decreased odds for hyperkalemia (OR 0.068, p=0.022).

Conclusions:

  • RASB is not associated with an increased risk of hyperkalemia in chronic HD patients.
  • RASB may even be associated with a reduced risk of hyperkalemia in this population.
Abstract

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