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

The DOI matches its Crossref record; 71 of the 71 references it cites were found in a registry or an index.

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
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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.

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  1. Parving, 2012, Cardiorenal end points in a trial of aliskiren for type 2 diabetes, N Engl J Med, 367, 2204, 10.1056/NEJMoa1208799 · DOI · Paper page

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Metadata

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 › Nephrology › 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

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