title: What is the risk of hyperkalaemia in heart failure?
abstract: BACKGROUND
  Chronic heart failure (CHF) is the only major cardiovascular disease whose prevalence and incidence are thought to be increasing. Potassium balance may be lost both through the neurohormonal mechanisms involved in cardiovascular diseases and through the drugs used in their treatment. Avoiding both hypo- and hyperkalemia is difficult but beneficial in CHF.
  
  
  METHODS
  Aldosterone production is decreased in the elderly, diabetic patients, and those receiving drugs that block the production or action of renin and angiotensin II. As a result, these groups, as well as those with already impaired potassium excretion due to progressive age or disease-related decline in glomerular filtration rate, are particularly vulnerable to the development of hyperkalemia.
  
  
  CONCLUSIONS
  Evidence from several studies suggests that, in patients with CHF, serum potassium should be maintained between 4.0 and 5.5 mEq/L. To gain the maximum benefit from aldosterone antagonists it is necessary to individualize their use; it is also necessary to carefully monitor electrolytes.
authors.affiliation: Medical University of Lodz, WAM University Hospital in Lodz, Department of Hypertension, Zeromskiego 113, 90-549 Lodz, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Bielecka-Dabrowa
authors.forename: Jacek
authors.initials: J
authors.lastname: Rysz
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
mesh_terms: D006333:Heart Failure / Q000097:blood / Q000150:complications*; D006706:Homeostasis; D006801:Humans; D006947:Hyperkalemia / Q000097:blood / Q000150:complications*; D044382:Population Groups; D011188:Potassium / Q000378:metabolism; D015221:Potassium Channels / Q000378:metabolism; D012307:Risk Factors; D026941:Sodium Channel Blockers / Q000627:therapeutic use; D013148:Spironolactone / Q000494:pharmacology
chemical_list: D015221:Potassium Channels; D026941:Sodium Channel Blockers; D013148:Spironolactone; D011188:Potassium