主催: The Japanese Pharmacological Society, The Japanese Society of Clinical Pharmacology
会議名: WCP2018 (18th World Congress of Basic and Clinical Pharmacology)
開催地: Kyoto
開催日: 2018/07/01 - 2018/07/06
Background
RAAS blockers [Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB)] is mainstay for treating hypertension and congestive heart failure. Hyperkalemia is concerned for patients receiving RAAS blockers. Risk factor for hyperkalemia related with RAAS blockers is chronic kidney disease (CKD), concomitant use of spironolactone and trimethoprim-sulfamethoxazole. In this study, we evaluate the relationship between body weight and hyperkalemia related with RAAS blockers.
Methods
Study design is retrospective analysis from medical records. Patients receiving RAAS blockers from 2015.6.1 to 2017.6.31 at Tokyo Women's Medical University Medical Center East was included. Patient background, comorbidity, concomitant medications, laboratory value were collected. Hyperkalemia was defined potassium more than 5.5 meq/L. Concomitant use of ACEI and ARB, aldosterone antagonists, direct renin inhibitor, sulfamethoxazole-trimethoprim, and nonsteroidal anti-inflammatory drugs (NSAIDs) was regarded as hyperkalemia inducing medications. The relationship between body weight and hyperkalemia related with RAAS blockers was assessed using multiple logistic regression analysis.
Results
2987 patients were included. Age of patients was 70.1±12.9 years, 61.0 % of patients were male, 27.9 % of patients had diabetes, 12.9 % patients had heart failure. 55.7 % of patients had CKD. Body weight was 60.8±14.1 kg. The incidence of hyperkalemia was 7.8 %. Multiple logistic regression analysis revealed that male, body weight, diabetes, history of hyperkalemia, eGFR < 30 mL/min/1.73m2, and concomitant use of hyperkalemia inducing medications were independent risk factors for hyperkalemia related with RAAS blockers.
Conclusions
This study demonstrated that male, body weight, diabetes, history of hyperkalemia, eGFR < 30 mL/min/1.73m2, concomitant use of hyperkalemia inducing medications was risk factor for hyperkalemia related with RAAS blockers. Body weight is useful information to identify potential risk for hyperkalemia related with RAAS blockers. Close monitoring of potassium level is required.
