Add-on Therapy of Potassium-exchange Resin for Hrkalemia in Chronic Kidney Disease Patients on Renin-angiotensin System Blockers.
- Author:
Joo Hark YI
1
;
Yeo Wook YUN
;
Useok NOH
;
Eun Young KIM
;
Jae Il PARK
;
Sang Woong HAN
;
Ho Jung KIM
Author Information
1. Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea. kimhj@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Hyperkalemia;
Renal insufficiency;
Angiotensin-converting enzyme inhibitors;
Angiotensin II type 1 receptor blockers
- MeSH:
Ambulatory Care;
Angiotensin II Type 1 Receptor Blockers;
Angiotensin-Converting Enzyme Inhibitors;
Creatinine;
Diet;
Humans;
Hyperkalemia;
Prospective Studies;
Renal Insufficiency;
Renal Insufficiency, Chronic*;
Renin-Angiotensin System*
- From:Korean Journal of Nephrology
2007;26(5):534-540
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This prospective study aimed to evaluate the safety and efficacy of potassium-exchange resin (PER, Kalimate(R) or Argamate(R)) for managing hyperkalemia induced by Renin-Angiotensin System (RAS) blockers in chronic kidney disease (CKD) patients without their discontinuation. METHODS: Besides conservative remedies including low-potassium diet, all hyperkalemic CKD patients (n=21, [K] > or =5.6 mEq/L) received PER added on angiotensin-converting enzyme inhibitor (Moexipril, n=2) or angiotensin-receptor blocker (Irbesartan, n=19) with, at least, weekly monitoring of serum [K] if its level remains more than 5.5 mEq/L for more than 2 months (mean+/-SD, 6.8+/-5.9 mon; range, 2-26 mon). RESULTS: Baseline serum [K] on RAS blocker alone (5.1+/-0.4 mEq/L; 4.2-6.3 mEq/L) increased to 6.0 +/-0.4 mEq/L (p<0.05) before adding PER, and then it was significantly decreased to 5.3+/-0.6 mEq/L at the first clinic visit (p<0.05) and to 5.0+/-0.7 mEq/L at the last clinic visit (p<0.05) following the administration of PER added on RAS blocker. During the study period, GFR, serum creatinine and urinary protein excretion didn't change significantly. CONCLUSION: The development of hyperkalemia on RAS blockers in CKD patients doesn't necessarily lead to withdrawal of RAS blockers when the cautious add-on therapy of potassium-exchange resin with other conservative remedies launches, unless severe refractory hyperkalemia persists.
