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Hyperkalemia in the Hypertensive Patient
Jay Ian Lakkis1, Matthew R Weir2
1University of Hawaii John A. Burns School of Medicine, 95 Maui Lani Pkwy, Wailuku, HI, 96793-2416, USA.
Current Cardiology Reports
|March 2, 2018
Summary
Hyperkalemia, or high potassium, is a risk for patients with hypertension, kidney disease, or diabetes. New therapies allow continued use of vital RAASi medications despite hyperkalemia.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Hyperkalemia is a common complication in patients with systemic arterial hypertension (HTN), particularly those with chronic kidney disease (CKD), diabetes mellitus (DM), or heart failure (HF).
- Pharmacological therapies, especially renin-angiotensin-aldosterone inhibitors (RAASi), can interfere with potassium homeostasis, increasing hyperkalemia risk.
- Hyperkalemia significantly contributes to morbidity, including emergency department visits and hospitalizations, and is associated with increased mortality risk.
Purpose of the Study:
- Identify risk factors for hyperkalemia in patients with HTN.
- Evaluate the risk-benefit profile of RAASi in specific patient populations.
- Outline preventive and therapeutic strategies for managing hyperkalemia.
Main Methods:
- Review of current literature on hyperkalemia risk factors and management.
- Analysis of evidence supporting the use of novel cation-exchange resins.
- Assessment of safety and efficacy data for patiromer and sodium zirconium cyclosilicate.
Main Results:
- Novel cation-exchange polymers (patiromer, sodium zirconium cyclosilicate) demonstrate safety and efficacy.
- These agents enable continued RAASi therapy in patients who develop hyperkalemia.
- This allows patients to maintain beneficial RAASi treatment without necessitating drug withdrawal.
Conclusions:
- Cation-exchange polymers offer a new, safe strategy for managing hyperkalemia in patients requiring RAASi.
- These therapies facilitate the continuation of RAASi, optimizing treatment for conditions like HTN, CKD, DM, and HF.
- Effective hyperkalemia management with novel agents improves patient outcomes and adherence to guideline-directed medical therapy.
Keywords:
Cation-exchange resinsChronic kidney diseaseDiabetic kidney diseaseHeart failureHyperkalemiaRenin-angiotensin-aldosterone inhibitorsMore Related Videos
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