Hyperkalemia Risk and Treatment of Heart Failure

  • Julian Segura
  • Luis M. Ruilope


The development of progressive renal dysfunction is indeed a frequent complication in heart failure (HF) and represents the consequence of the combined effects of progressive decay in cardiac output and renal perfusion pressure, in conjunction with excess renal vasoconstriction. In fact, factors predisposing the development of HF such as ageing, hypertension, and myocardial ischemia are also frequently accompanied by a diminished renal function. Frequently, the degree and impact of renal dysfunction and its impact on outcomes in patients with HF are often underdiagnosed and underestimated. This is especially relevant considering that a decreased renal function is associated with a significant increment in mortality in HF. Several evidences have demonstrated the efficacy of renin–angiotensin–aldosterone blockade as a relevant component of HF treatment. However, the benefits of HF therapy do not come without some risk, and hyperkalemia is a frequent finding, especially in presence of renal dysfunction. We will review the participation of the kidney in HF and the renal consequences of the treatment, with special emphasis on the risk of hyperkalemia and its management in daily clinical practice.


Heart Failure Chronic Kidney Disease Glomerular Filtration Rate Left Ventricular Ejection Fraction Heart Failure Patient 
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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Nephrology DepartmentHypertension UnitMadridSpain

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