title: Ramipril and risk of hyperkalemia in chronic hemodialysis patients.
abstract: Angiotensin converting enzyme (ACE) inhibitors provide well known cardiorenal-protective benefits added to antihypertensive effects in chronic renal disease. These agents are underused in management of patients receiving hemodialysis (HD) because of common concern of hyperkalemia. However, few studies have investigated effect of renin angiotensin aldosterone system (RAAS) blockade on serum potassium in hemodialysis patients. We assessed the safety of ramipril in patients on maintenance HD. We enrolled 28 adult end stage renal disease (ESRD) patients treated by maintenance HD and prescribed them ramipril in doses of 1.25 to 5 mg per day. They underwent serum potassium concentration measurements before ramipril introduction and in 1 to 3 months afterwards. No significant increase in kalemia was found. Results of our study encourage the use of ACE inhibitors in chronically hemodialyzed patients, but close potassium monitoring is mandatory.
authors.affiliation: Vinkovci General Hospital, Department of Internal Medicine, Vinkovci, Croatia. mirna.k1@hotmail.com
authors.forename: Mirna
authors.initials: M
authors.lastname: Krajina-Andricević
authors.forename: Lada
authors.initials: L
authors.lastname: Zibar
authors.forename: Karin
authors.initials: K
authors.lastname: Juras
authors.forename: Sanda
authors.initials: S
authors.lastname: Goll-Barić
authors.forename: Jerko
authors.initials: J
authors.lastname: Barbić
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D017257:Ramipril / Q000009:adverse effects*; D006435:Renal Dialysis; D012084:Renin-Angiotensin System / Q000187:drug effects
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D017257:Ramipril