Abstract:
BACKGROUND:Serious hyperkalemia was reported in 10% of chronic hemodialysis (HD) patients that could lead to arrhythmia and death. Angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin II receptor blockers (ARB) are well accepted for cardio-protective benefits. The relationship between renin-angiotensin system blockade (RASB) and hyperkalemia in chronic HD patients remains controversial. The aim of this study was to find the relationship between RASB and hyperkalemia in these patients. METHODS:Pre-dialysis serum potassium, clinical factors, and drugs were evaluated in 200 chronic HD patients in one HD center. Hyperkalemia was defined as serum K >or= 5.3 meq/L. Finally, multivariate analysis with logistic regression was used to evaluate the risk of hyperkalemia by RASB and other factors. RESULTS:In 200 patients, the mean K was 4.93 +/- 0.79 meq/L, and 70 (35%) patients had hyperkalemia. Fifty-eight (29%) patients were prescribed with RASB. Seven variables--non-DM, longer HD duration, lower dialysate calcium, lower serum glucose, higher serum iPTH, not using RASB, and not using furosemide--were more frequent in hyperkalemia group. In logistic regression analysis, RASB was associated with decreased odds for hyperkalemia (OR 0.262, p = 0.001 in model A; OR 0.205, p = 0.001 in model B). In addition, furosemide was associated with decreased odds for hyperkalemia (OR 0.068, p = 0.022 in model B). CONCLUSIONS:RASB is not associated with hyperkalemia in chronic HD patients.
journal_name
Ren Failjournal_title
Renal failureauthors
Lin HH,Yang YF,Chang JK,Ting IW,Kuo HL,Wang IK,Huang CCdoi
10.3109/08860220903216147subject
Has Abstractpub_date
2009-01-01 00:00:00pages
942-5issue
10eissn
0886-022Xissn
1525-6049journal_volume
31pub_type
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