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Add-on Therapy of Potassium-exchange Resin for Hrkalemia in Chronic Kidney Disease Patients on Renin-angiotensin System Blockers / 대한신장학회지
Korean Journal of Nephrology ; : 534-540, 2007.
Article in Korean | WPRIM | ID: wpr-41487
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.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Renin-Angiotensin System / Angiotensin-Converting Enzyme Inhibitors / Prospective Studies / Creatinine / Angiotensin II Type 1 Receptor Blockers / Diet / Renal Insufficiency / Renal Insufficiency, Chronic / Ambulatory Care / Hyperkalemia Type of study: Observational study Limits: Humans Language: Korean Journal: Korean Journal of Nephrology Year: 2007 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Renin-Angiotensin System / Angiotensin-Converting Enzyme Inhibitors / Prospective Studies / Creatinine / Angiotensin II Type 1 Receptor Blockers / Diet / Renal Insufficiency / Renal Insufficiency, Chronic / Ambulatory Care / Hyperkalemia Type of study: Observational study Limits: Humans Language: Korean Journal: Korean Journal of Nephrology Year: 2007 Type: Article