Dear Mike,
Considering her GFR and Creatinine at the most a dose reduction of ARB along with a thiazide diuretic could be considered.
Pottasium of 6.0 maked me a little uncomfortable. Advanced CKD patients tolerate hyperkalemia better than early mild CKD.I have very recently seen a patient of stage 5 CkD with pottasium of 7.1 with absolutely no symptoms.Although she was hospitalised stat for management.
Regards,
Sutirtha
-----Original message-----
From: Hallworth Mike (RLZ)
Sent: 31/10/2012, 9:52 pm
To: [log in to unmask]
Subject: RE: Hyperkalaemia on ARB's
Hi Sutirtha,
Urea = 8.1 mmol/L, Creat = 103 umol/l, eGFR = 45 ml/min
No NSAIDS
Ventolin/Omeprazole/Simvastatin/Amitriptyline/Co-codamol/Folate/Mesalazi
ne
Mike
-----Original Message-----
From: [log in to unmask]
[mailto:[log in to unmask]]
Sent: 31 October 2012 16:07
To: Hallworth Mike (RLZ)
Cc: [log in to unmask]
Subject: RE: Hyperkalaemia on ARB's
Dear Mike,
what other drugs is the patient on.Is she on NSAIDs. what about her
renal function.
regards
Sutirtha
-----Original message-----
From: Hallworth Mike (RLZ)
Sent: 30/10/2012, 11:55 pm
To: [log in to unmask]
Subject: RE: Hyperkalaemia on ARB's
Many thanks! - that's helpful. No, she is not diabetic. What details did
you want?
Mike
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of
[log in to unmask]
Sent: 30 October 2012 17:37
To: [log in to unmask]
Subject: Re: Hyperkalaemia on ARB's
Dear Mike,
Its an interesting query.Literature is quite varied but the conclusion
is possibly all ARB have simmilar risk of hyperkalemia.
Is the patient diabetic? If not I think a different class of drug will
be helpful.
Can you please send me the patient details.
regards
Sutirtha
-----Original message-----
From: Hallworth Mike (RLZ)
Sent: 30/10/2012, 8:33 pm
To: [log in to unmask]
Subject: Hyperkalaemia on ARB's
Hi all
I have been consulted about a patient with persistent moderate
hyperkalaemia, (K+ running 5.8-6.2 mmol/L). Many of the usual suspects
have been excluded, but she is on valsartan. ARBs cause hyperkalaemia
less often than ACE inhibitors, but it is described as a side-effect and
a change of Rx is being considered. Does anyone know whether an
alternative ARB is worth trying, or if it is a class effect and we need
to change to a different class of antihypertensive?
Thanks in anticipation,
Mike
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