[Dangerous hyperkalemia as sequelae of new treatment strategies of heart failure].
This case report presents a patient who developed severe life-threatening hyperkalemia following combined treatment with an ACE-inhibitor and the aldosterone-antagonist spironolactone for his congestive heart failure and who also suffered from pre-existing moderate renal failure. The pathophysiological reasons and the clinical evidence for the treatment of congestive heart failure with a combination of ACE-inhibitors and aldosterone-antagonists are discussed in details. The reasons for the occurrence of hyperkalemia in this patient and how spironolactone should be prescribed in patients with congestive heart failure are also elucidated.
Fuster
D
D
Abteilung für Nephrologie und Hypertonie, Inselspital, Universität Bern.
Frey
F J
FJ
Ferrari
P
P
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D002216:Captopril / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced* / Q000175:diagnosis; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D013148:Spironolactone / Q000009:adverse effects* / Q000627:therapeutic use
D000806:Angiotensin-Converting Enzyme Inhibitors; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D002216:Captopril