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ACB-CLIN-CHEM-GEN  October 2012

ACB-CLIN-CHEM-GEN October 2012

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Subject:

Re: Hyperkalaemia on ARB's

From:

"[log in to unmask]" <[log in to unmask]>

Reply-To:

[log in to unmask]

Date:

Wed, 31 Oct 2012 17:16:19 +0000

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Dear Dr John,

All electrolyte imbalance follow one rule that is severity of clinical manifestation is dependent on the gradient of change rather than absolute value.
If the original baseline levels are not known a pottasium of 6.0 seems to be significant.
Looking forward for your inputs.

Regards,
Dr Sutirtha Chakraborty, MD, FACB
Consultant, Clinical Biochemistry,
Peerless Hospital,Kolkata,700094
INDIA

-----Original message-----
From: John Francis Doran (ABM ULHB - Biochemistry)
Sent:  31/10/2012, 9:47  pm
To: [log in to unmask]; [log in to unmask]
Subject: RE: Hyperkalaemia on ARB's


How about a bit of provocation.
Let's assume that the K+ result is due to Valsartan. While K+ is outside the reference limit, does it matter?  
John
John F Doran
Consultant Chemical Pathologist
ABMU LHB
[log in to unmask]
P Helpwch arbed papur - oes angen i chi printio'r e-bost yma? / Help save paper - do you need to print this e mail? 

 

-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of [log in to unmask]
Sent: 31 October 2012 16:07
To: [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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