CoChat
Sign Up
Cited by 164Potassium and Related DisordersChronic Kidney Disease and DiabetesParathyroid Disorders and Treatments

Prediction and Management of Hyperkalemia Across the Spectrum of Chronic Kidney Disease

Lazich, Ivana, Bakris, George L.·2014·Seminars in Nephrology
DOI 10.1016/j.semnephrol.2014.04.008
Open this paper in CoChat — free account

Abstract

Hyperkalemia commonly limits optimizing treatment to slow stage 3 or higher chronic kidney disease (CKD) progression. The risk of hyperkalemia is linked to dietary potassium intake, level of kidney function, concomitant diseases that may affect potassium balance such as diabetes, and use of medications that influence potassium excretion. The risk predictors for developing hyperkalemia are an estimated glomerular filtration rate of less than 45 mL/min/1.73 m(2) and a serum potassium level greater than 4.5 mEq/L in the absence of blockers of the renin-angiotensin-aldosterone system (RAAS). Generally, monotherapy with RAAS blockers does not increase risk substantially unless hypotension or volume depletion occur. Dual RAAS blockade involving any combination of an angiotensin-converting enzyme inhibitor, angiotensin-receptor blocker, renin inhibition, or aldosterone-receptor blocker markedly increases the risk of hyperkalemia in patients with stage 3 or higher CKD. Moreover, dual RAAS blockade further reduces albuminuria by 25% to 30% compared with monotherapy, it has failed to show a benefit on CKD progression or cardiovascular outcome, and thus is not indicated in such patients because of its marked increase in hyperkalemia potential. Although sodium polystyrene resins exist to manage hyperkalemia in patients requiring therapy that increases serum potassium levels, they are not well tolerated. Newer, more predictable, better-tolerated polymers to bind potassium are on the horizon and may be approved within the next 1 to 2 years.

Integrity signals

Registry

Crossref · 10.1016/j.semnephrol.2014.04.008

Cites

71 of 71 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The use of spironolactone as a fourth drug is limited by tolerability issues in some patients, including the development of hyperkalemia in those with CKD with an eGFR <45 mL⋅min−1⋅1.73 m−2 or baseline serum potassium >4.5 mEq/L.

    “However, the use of spironolactone as a fourth drug is limited by tolerability issues in some patients, including the development of hyperkalemia in those with CKD with an eGFR <45 mL⋅min−1⋅1.73 m−2 or baseline serum potassium >4.5 mEq/L.378”

    From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [378]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Lazich, I., & Bakris, G. L.
Affiliations
University of Chicago (US)
Corresponding author
Bakris, George L.
ORCID
Bakris, George L.
Venue
Seminars in Nephrology
Publisher
Elsevier BV
Published
2014-05
Volume
34
Issue
3
Pages
333-339
ISSN
0270-9295 (ISSN-L)
DOI
10.1016/j.semnephrol.2014.04.008
OpenAlex
W2072577267
Cited by
164
References
71
Citations by year
2026: 2 · 2025: 6 · 2024: 5 · 2023: 15 · 2022: 10 · 2021: 26 · 2020: 28 · 2019: 16 · 2018: 16 · 2017: 14 · 2016: 15 · 2015: 10 · 2014: 1
FWCI
2.28
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Seminars in Nephrology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Potassium and Related Disorders
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
Keywords
hyperkalemia, chronic kidney disease, risk prediction, potassium intake, renin-angiotensin-aldosterone system inhibitors, albuminuria, estimated glomerular filtration rate, chronic kidney disease progression
MeSH terms
Mineralocorticoid Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Glomerular Filtration Rate, Humans, Hyperkalemia, Potassium, Renal Insufficiency, Chronic, Angiotensin Receptor Antagonists

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review