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Hyperkalemia After ...
Hyperkalemia After Initiating Renin-Angiotensin System Blockade : The Stockholm Creatinine Measurements (SCREAM) Project
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- Bandak, Ghassan (författare)
- Johns Hopkins Univ, Dept Med, Div Nephrol, Baltimore, MD USA.
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- Sang, Yingying (författare)
- Johns Hopkins Univ, Dept Epidemiol, Bloomberg Sch Publ Hlth, Baltimore, MD USA.
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- Gasparini, Alessandro (författare)
- Karolinska Institutet,Karolinska Inst, Div Renal Med, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
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- Chang, Alex R. (författare)
- Geisinger Hlth Syst, Div Nephrol, Danville, PA USA.
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- Ballew, Shoshana H. (författare)
- Johns Hopkins Univ, Dept Epidemiol, Bloomberg Sch Publ Hlth, Baltimore, MD USA.
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- Evans, Marie (författare)
- Karolinska Institutet,Karolinska Inst, Div Renal Med, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
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- Ärnlöv, Johan, 1970- (författare)
- Högskolan Dalarna,Karolinska Institutet,Uppsala universitet,Kardiovaskulär epidemiologi,Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden.,Medicinsk vetenskap
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- Lund, Lars H. (författare)
- Karolinska Institutet,Karolinska Inst, Unit Cardiol, Dept Med, Stockholm, Sweden.
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- Inker, Lesley A. (författare)
- Tufts Med Ctr, Div Nephrol, Boston, MA USA.
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- Coresh, Josef (författare)
- Johns Hopkins Univ, Dept Epidemiol, Bloomberg Sch Publ Hlth, Baltimore, MD USA.
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- Carrero, Juan-Jesus (författare)
- Karolinska Institutet,Karolinska Inst, Div Renal Med, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
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- Grams, Morgan E. (författare)
- Johns Hopkins Univ, Dept Med, Div Nephrol, Baltimore, MD USA.;Johns Hopkins Univ, Dept Epidemiol, Bloomberg Sch Publ Hlth, Baltimore, MD USA.
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Johns Hopkins Univ, Dept Med, Div Nephrol, Baltimore, MD USA Johns Hopkins Univ, Dept Epidemiol, Bloomberg Sch Publ Hlth, Baltimore, MD USA. (creator_code:org_t)
- WILEY, 2017
- 2017
- Engelska.
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Ingår i: Journal of the American Heart Association. - : WILEY. - 2047-9980. ; 6:7
- Relaterad länk:
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https://doi.org/10.1...
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https://du.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Background: Concerns about hyperkalemia limit the use of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs), but guidelines conflict regarding potassium-monitoring protocols. We quantified hyperkalemia monitoring and risks after ACE-I/ARB initiation and developed and validated a hyperkalemia susceptibility score.Methods and Results: We evaluated 69 426 new users of ACE-I/ARB therapy in the Stockholm Creatinine Measurements (SCREAM) project with medication initiation from January 1, 2007 to December 31, 2010, and follow-up for 1 year thereafter. Three fourths (76%) of SCREAM patients had potassium checked within the first year. Potassium >5 and >5.5 mmol/L occurred in 5.6% and 1.7%, respectively. As a comparison, we propensity-matched new ACE-I/ARB users to 20 186 new beta-blocker users in SCREAM: 64% had potassium checked. The occurrence of elevated potassium levels was similar between new beta-blocker and ACEI/ARB users without kidney disease; only at estimated glomerular filtration rate <60 mL/min per 1.73 m(2) were risks higher among ACE-I/ARB users. We developed a hyperkalemia susceptibility score that incorporated estimated glomerular filtration rate, baseline potassium level, sex, diabetes mellitus, heart failure, and the concomitant use of potassium-sparing diuretics in new ACE-I/ARB users; this score accurately predicted 1-year hyperkalemia risk in the SCREAM cohort (area under the curve, 0.845, 95% CI: 0.840-0.869) and in a validation cohort from the US-based Geisinger Health System (N=19 524; area under the curve, 0.818, 95% CI: 0.794-0.841), with good calibration.Conclusions: Hyperkalemia within the first year of ACE-I/ARB therapy was relatively uncommon among people with estimated glomerular filtration rate >60 mL/min per 1.73 m(2), but rates were much higher with lower estimated glomerular filtration rate. Use of the hyperkalemia susceptibility score may help guide laboratory monitoring and prescribing strategies.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Nyckelord
- angiotensin-converting enzyme inhibitors
- angiotensin receptor blockers
- angiotensin-converting enzyme inhibition
- chronic kidney disease
- hyperkalemia
- potassium
- risk score
- Hälsa och välfärd
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
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Bandak, Ghassan
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Sang, Yingying
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Gasparini, Aless ...
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Chang, Alex R.
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Ballew, Shoshana ...
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Evans, Marie
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Ärnlöv, Johan, 1 ...
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Lund, Lars H.
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Inker, Lesley A.
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Coresh, Josef
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Carrero, Juan-Je ...
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Grams, Morgan E.
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
- Artiklar i publikationen
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Journal of the A ...
- Av lärosätet
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Uppsala universitet
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Karolinska Institutet
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Högskolan Dalarna