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Diuretics and the institutional elderly: a case against routine potassium prescribing

P J Henschke, J D Spence, R D Cape

    Journal of the American Geriatrics Society
    |April 1, 1981
    PubMed
    Summary

    Withdrawing potassium supplements in elderly patients on diuretics did not lead to intracellular potassium depletion, suggesting routine supplementation may be unnecessary and risky. Therapy should be reserved for high-risk individuals.

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    Area of Science:

    • Geriatric Medicine
    • Cardiology
    • Clinical Pharmacology

    Background:

    • Diuretic therapy for cardiac failure can lead to potassium (K) loss.
    • Routine oral potassium (K) supplementation is common in patients receiving diuretics.
    • The necessity and safety of routine K supplementation require further investigation.

    Purpose of the Study:

    • To evaluate the impact of withdrawing oral potassium (K) supplements on plasma and erythrocyte K levels in elderly male residents receiving diuretic therapy.
    • To determine if diuretic-induced hypokalemia is associated with intracellular K depletion.
    • To assess the need for routine K supplementation or K-sparing agents in this patient population.

    Main Methods:

    • A study was conducted on 14 elderly male residents receiving diuretic therapy for cardiac failure.

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  • Oral potassium (K) supplements were withdrawn for six weeks, with plasma and erythrocyte K levels measured before and after.
  • A control group of 19 healthy elderly residents was included for comparison.

    • Main Results:

    • Withdrawal of potassium (K) supplements led to a significant decrease in mean plasma K levels.
    • Mean erythrocyte K levels remained unchanged and were comparable to control values.
    • Treatment with Aldactazide increased plasma K levels but did not alter erythrocyte K levels.

    Conclusions:

    • Diuretic-induced hypokalemia may not always correlate with intracellular potassium (K) depletion.
    • Routine potassium (K) supplementation or K-sparing agents might be unnecessary and carry risks for certain patients.
    • Targeted K supplementation should be reserved for patients with specific risk factors for K depletion.