TY - JOUR
T1 - Factors predicting hyperkalemia in patients with cirrhosis receiving spironolactone
AU - Abbas, Zaigham
AU - Mumtaz, Khalid
AU - Salam, Abdul
AU - Jafri, Wasim
PY - 2003/7/1
Y1 - 2003/7/1
N2 - Objective: To evaluate the factors leading to hyperkalemia in patients with cirrhosis receiving spironolactone. Design: An observational, analytical, case control study. Place and Duration of Study: The Aga Khan University Hospital. Six months. Subjects and Methods: One hundred and fifty consecutive patients (100 males, 50 females) with cirrhosis of liver, hospitalized for decompensated disease and receiving spironolactone for at least two weeks before admission, were included in this study. Patients with hyperkalemia (n=67) having potassium level >5 mmol/l were compared with patients who had normal potassium level 5 mmol/l (n=83). The parameters taken into account were age, gender of the patients, type and dose of diuretics along with concomitant medicines, diastolic blood pressure, edema, ascites, blood urea nitrogen, serum creatinine, electrolytes, bilirubin, albumin, prothrombin time, Child class, and Child Pugh score. Results: Patients with hyperkalemia (K > 5 mmol/l) had higher blood urea nitrogen, serum creatinine and bilirubin levels (p= 0.004, 0.001 and 0.044 respectively). Their serum sodium and albumin levels were lower (p= 0.000 and 0.017 respectively). They had advanced cirrhosis with high Pugh score (p= 0.003). These patients were on higher dose of spironolactone (p =0.001). Multivariate analysis showed that dose of spironolactone >100 mg /day, serum creatinine >1.3 mg/dl, persistence of ascites and edema, and female gender were important predictors of development of hyperkalemia. Conclusion: Patients with cirrhosis receiving high dose of the diuretic, having edema, ascites and high serum creatinine are at the greater risk of developing hyperkalemia during spironolactone therapy.
AB - Objective: To evaluate the factors leading to hyperkalemia in patients with cirrhosis receiving spironolactone. Design: An observational, analytical, case control study. Place and Duration of Study: The Aga Khan University Hospital. Six months. Subjects and Methods: One hundred and fifty consecutive patients (100 males, 50 females) with cirrhosis of liver, hospitalized for decompensated disease and receiving spironolactone for at least two weeks before admission, were included in this study. Patients with hyperkalemia (n=67) having potassium level >5 mmol/l were compared with patients who had normal potassium level 5 mmol/l (n=83). The parameters taken into account were age, gender of the patients, type and dose of diuretics along with concomitant medicines, diastolic blood pressure, edema, ascites, blood urea nitrogen, serum creatinine, electrolytes, bilirubin, albumin, prothrombin time, Child class, and Child Pugh score. Results: Patients with hyperkalemia (K > 5 mmol/l) had higher blood urea nitrogen, serum creatinine and bilirubin levels (p= 0.004, 0.001 and 0.044 respectively). Their serum sodium and albumin levels were lower (p= 0.000 and 0.017 respectively). They had advanced cirrhosis with high Pugh score (p= 0.003). These patients were on higher dose of spironolactone (p =0.001). Multivariate analysis showed that dose of spironolactone >100 mg /day, serum creatinine >1.3 mg/dl, persistence of ascites and edema, and female gender were important predictors of development of hyperkalemia. Conclusion: Patients with cirrhosis receiving high dose of the diuretic, having edema, ascites and high serum creatinine are at the greater risk of developing hyperkalemia during spironolactone therapy.
KW - Cirrhosis
KW - Hyperkalemia
KW - Liver
KW - Potassium
KW - Spironolactone
UR - http://www.scopus.com/inward/record.url?scp=0041785459&partnerID=8YFLogxK
M3 - Article
C2 - 12887837
AN - SCOPUS:0041785459
SN - 1022-386X
VL - 13
SP - 382
EP - 384
JO - Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
JF - Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
IS - 7
ER -