00422055

open access

Version of Record

Life-threatening Hyperkalemia during a Combined Therapy with the Angiotensin Receptor Blocker Candesartan and Spironolactone

English (英語)

The Kobe journal of the medical sciences

51(1/2)

1-6

Kobe University School of Medicine

2005-06

2006-07-15

We describe a hypertensive nephrosclerosis patient presenting with severehyperkalemia due to a combination therapy of the angiotensin receptor blocker (ARB)candesartan and spironolactone despite mildly decreased renal function. Recently,ARBs are replacing the ACE inhibitors. The combined therapy with ARB andspironolactone will eventually become the standard regimen. The strict attention andclose monitoring of serum potassium should be mandatory in combination therapy toprevent hyperkalemia. Assessment of trans-tubular potassium gradient (TTKG) andfractional excretion of potassium (FEK) before starting the therapy would help inidentifying the patients at higher risk of developing hyperkalemia. Co-administrationof thiazide or loop diuretics is recommended to reduce the risk of hyperkalemia.

Hyperkalemia

紀要論文