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Tytuł:
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The pharmacotherapeutic management of hyperkalemia in patients with cardiovascular disease.
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Autorzy:
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Tamargo J; Department of Pharmacology, School of Medicine, Universidad Complutense, Instituto De Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Caballero R; Department of Pharmacology, School of Medicine, Universidad Complutense, Instituto De Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Delpón E; Department of Pharmacology, School of Medicine, Universidad Complutense, Instituto De Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
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Źródło:
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Expert opinion on pharmacotherapy [Expert Opin Pharmacother] 2021 Jul; Vol. 22 (10), pp. 1319-1341. Date of Electronic Publication: 2021 Apr 21.
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Typ publikacji:
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Journal Article; Review
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Język:
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English
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Imprint Name(s):
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Publication: London : Informa Healthcare
Original Publication: London : Ashley Publications, c1999-
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MeSH Terms:
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Cardiovascular Diseases*/complications
Cardiovascular Diseases*/drug therapy
Hyperkalemia*/drug therapy
Renal Insufficiency, Chronic*/complications
Renal Insufficiency, Chronic*/drug therapy
Humans ; Mineralocorticoid Receptor Antagonists ; Potassium ; Renin-Angiotensin System
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Contributed Indexing:
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Keywords: Hyperkalemia; cardiovascular diseases; chronic treatment; emergency treatment; patiromer; renin-angiotensin-aldosterone system inhibitors; sodium zirconium cyclosilicate
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Substance Nomenclature:
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0 (Mineralocorticoid Receptor Antagonists)
RWP5GA015D (Potassium)
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Entry Date(s):
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Date Created: 20210223 Date Completed: 20210709 Latest Revision: 20210709
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Update Code:
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20240105
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DOI:
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10.1080/14656566.2021.1891223
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PMID:
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33620275
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Introduction : Patients with cardiovascular diseases (CVD) are at increased risk of hyperkalemia, particularly when treated with renin-angiotensin-aldosterone inhibitors (RAASIs). Because the occurrence or fear of hyperkalemia, RAASIs are frequently down-titrated or discontinued in patients with CVD, with consequent worse outcomes than patients who remain on maximum doses. Areas covered : This article reviews potassium homeostasis, epidemiology, risk factors, and outcomes of hyperkalemia, and efficacy and safety of the drugs used for acute and chronic treatment of hyperkalemia. A literature search was carried out using the PubMed and guidelines for the management of hyperkalemia. Expert opinion : The emergency treatment of hyperkalemia is not supported by high-quality evidence and clinical trials did not report drug effects on clinical outcomes. Two potassium binders, patiromer and sodium zirconium cyclosilicate, represent a new approach in the treatment of chronic hyperkalemia as they may allow the titration and maintenance of guidelines-recommended doses of RAASIs in patients with CVD who otherwise would not tolerate them due to the risk of hyperkalemia.Further studies are needed to evaluate the safety and efficacy of drug therapy and support the development of guidelines for acute and chronic hyperkalemia.