Abstract
Many commonly used drugs have the potential to cause hyperkalaemia via a variety of mechanisms. An increased awareness of the potential for drugs to induce hyperkalaemia, together with the use of preventative strategies, may minimize the risk of drug-induced hyperkalaemia.
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Sood MM, Sood AR, Richardson R. Emergency management and commonly encountered outpatient scenarios in patients with hyperkalemia. Mayo Clin Proc. 2007;82(12):1553–61.
Evans KJ, Greenberg A. Hyperkalemia: a review. J Intensive Care Med. 2005;20(5):272–90.
Ben Salem C, Badreddine A, Fathallah N, et al. Drug-induced hyperkalemia. Drug Saf. 2014;37(9):677–92.
Perazella MA. Drug-induced hyperkalemia: old cuplrits and new offenders. Am J Med. 2000;109(4):307–14.
Passare G, Viitanen M, Törring O, et al. Sodium and potassium disturbances in the elderly: prevalence and association with drug use. Clin Drug Investig. 2004;24(9):535–44.
Raebel MA. Hyperkalemia associated with use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Cardiovasc Ther. 2012;30(3):e156–66.
Reardon LC, Macpherson DS. Hyperkalemia in outpatients using angiotensin-converting enzyme inhibitors. How much should we worry? Arch Intern Med. 1998;158(1):26–32.
Miltiadous G, Mikhailidis DP, Elisaf M. Acid-base and electrolyte abnormalities observed in patients receiving cardiovascular drugs. J Cardiovasc Pharmacol Ther. 2003;8(4):267–76.
Roscioni SS, de Zeeuw D, Bakker SJ, et al. Management of hyperkalaemia consequent to mineralocorticoid-receptor antagonist therapy. Nat Rev Nephrol. 2012;8(12):691–9.
White WB, Bresalier R, Kaplan AP, et al. Safety and tolerability of the direct renin inhibitor aliskiren: a pooled analysis of clinical experience in more than 12,000 patients with hypertension. J Clin Hypertens (Greenwich). 2010;12(10):765–75.
Parving HH, Brenner BM, McMurray JJ, et al. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med. 2012;367(23):2204–13.
Weir MR, Bush C, Anderson DR, et al. Antihypertensive efficacy, safety, and tolerability of the oral direct renin inhibitor aliskiren in patients with hypertension: a pooled analysis. J Am Soc Hypertens. 2007;1(4):264–77.
Harel Z, Gilbert C, Wald R, et al. The effect of combination treatment with aliskiren and blockers of the renin-angiotensin system on hyperkalaemia and acute kidney injury: systematic review and meta-analysis. BMJ. 2012;344:e42.
Appel GB, Radhakrishnan J, Avram MM, et al. Analysis of metabolic parameters as predictors of risk in the RENAAL study. Diabetes Care. 2003;26(5):1402–7.
Miao Y, Dobre D, Heerspink HJ, et al. Increased serum potassium affects renal outcomes: a post hoc analysis of the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) trial. Diabetologia. 2011;54(1):44–50.
Rangel EB. The metabolic and toxicological considerations for immunosuppressive drugs used during pancreas transplantation. Expert Opin Drug Metab Toxicol. 2012;8(12):1531–48.
Palmer BF. Managing hyperkalemia caused by inhibitors of the renin-angiotensin-aldosterone system. N Engl J Med. 2004;351(6):585–92.
Oster JR, Singer I, Fishman LM. Heparin-induced aldosterone suppression and hyperkalemia. Am J Med. 1995;98(6):575–86.
Gheno G, Cinetto L, Savarino C, et al. Variations of serum potassium level and risk of hyperkalemia in inpatients receiving low-molecular-weight heparin. Eur J Clin Pharmacol. 2003;59(5–6):373–7.
Koren-Michowitz M, Avni B, Michowitz Y, et al. Early onset of hyperkalemia in patients treated with low molecular weight heparin: a prospective study. Pharmacoepidemiol Drug Saf. 2004;13(5):299–302.
Harirforoosh S, Jamali F. Renal adverse effects of nonsteroidal anti-inflammatory drugs. Expert Opin Drug Saf. 2009;8(6):669–81.
Lafrance JP, Miller DR. Dispensed selective and nonselective nonsteroidal anti-inflammatory drugs and the risk of moderate to severe hyperkalemia: a nested case-control study. Am J Kidney Dis. 2012;60(1):82–9.
Aljadhey H, Tu W, Hansen RA, et al. Risk of hyperkalemia associated with selective COX-2 inhibitors. Pharmacoepidemiol Drug Saf. 2010;19(11):1194–8.
Funder JW. Eplerenone: hypertension, heart failure and the importance of mineralocorticoid receptor blockade. Future Cardiol. 2006;2(5):535–41.
Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999;341(10):709–17.
Pitt B, Bakris G, Ruilope LM, et al. Serum potassium and clinical outcomes in the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS). Circulation. 2008;118(16):1643–50.
Buff DD, Aboal AA. Pentamidine-associated renal dysfunction and hyperkalemia. Am J Med. 1990;88(5):552.
Quan KC, Kahana L. Clinical experience with the diuretic effects of triamterene alone and combined with hydrochlorothiazide. Curr Ther Res Clin Exp. 1964;6:27–34.
Perazella MA. Trimethoprim-induced hyperkalaemia: clinical data, mechanism, prevention and management. Drug Saf. 2000;22(3):227–36.
ECC Committee, Subcommittees and Task Forces of the American Heart Association. 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2005;112(24 Suppl):IV1–203.
Chapagain A, Ashman N. Hyperkalaemia in the age of aldosterone antagonism. QJM. 2012;105(11):1049–57.
Banerjee A, Stoica C, Walia A. Acute hyperkalemia as a complication of intravenous therapy with espilon-aminocaproic acid. J Clin Anesth. 2011;23(7):565–8.
Giovacchini G, Nicolas G, Fredidank H, et al. Effect of amino acid infusion on potassium serum levels in neuroendocrine tumour patients treated with targeted radiopeptide therapy. Eur J Nucl Med Mol Imaging. 2011;38(9):1675–82.
Hertz P, Richardson JA. Arginine-induced hyperkalemia in renal failure patients. Arch Intern Med. 1972;130(5):778–80.
Brass EP, Thompson WL. Drug-induced electrolyte abnormalities. Drugs. 1982;24(3):207–28.
Swenson ER. Severe hyperkalemia as a complication of timolol, a topically applied beta-adrenergic antagonist. Arch Intern Med. 1986;146(6):1220–1.
McCauley J, Murray J, Jordan M, et al. Labetalol-induced hyperkalemia in renal transplant recipients. Am J Nephrol. 2002;22(4):347–51.
Sica DA. Antihypertensive therapy and its effects on potassium homeostasis. J Clin Hypertens (Greenwich). 2006;8(1):67–73.
Freed MI, Rastegar A, Bia MJ. Effects of calcium channel blockers on potassium homeostasis. Yale J Biol Med. 1991;64(2):177–86.
Manini AF, Nelson LS, Hoffman RS. Prognostic utility of serum potassium in chronic digoxin toxicity: a case-control study. Am J Cardiovasc Drugs. 2011;11(3):173–8.
Tobita K, Kohno T. Case of hyperkalemia after the administration of hypertonic mannitol during craniotomy [in Japanese]. Masui. 2010;59(5):641–4.
Martyn JA, Richtseld M. Succinylcholine-induced hyperkalemia in acquired pathologic states: etiologic factors and molecular mechanisms. Anesthesiology. 2006;104(1):158–69.
Thiele A, Rehman HU. Hyperkalemia caused by penicillin. Am J Med. 2008;121(8):e1–2.
Zimrin AB, Hess JR. Current issues relating to the transfusion of stored red blood cells. Vox Sang. 2009;96(2):93–103.
Chen J, Singhapricha T, Memarzadeh M, et al. Storage age of transfused red blood cells during liver transplantation and its intraoperative and postoperative effects. World J Surg. 2012;36(10):2436–42.
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This article was adapted from Drug Safety 2014;37(9):677–92 [3] by salaried/contracted employees of Adis/Springer, and was not supported by any external funding.
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Adis Medical Writers. Minimize drug-induced hyperkalaemia by increasing awareness and using preventative strategies. Drugs Ther Perspect 31, 28–33 (2015). https://doi.org/10.1007/s40267-014-0171-z
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DOI: https://doi.org/10.1007/s40267-014-0171-z