Risk of Hyperkalemia in Nondiabetic Patients With Chronic Kidney Disease Receiving Antihypertensive TherapyHyperkalemia in CKD Adults Using Antihypertensives

Abstract

Several studies have demonstrated that angiotensin-converting enzyme inhibitors (ACEIs) blunt progression of renal disease in nondiabetic patients with chronic kidney disease (CKD).^1-4 However, ACEIs can cause hyperkalemia by impairing renal potassium excretion through interference with production and/or secretion of aldosterone.⁵ Hyperkalemia from ACEI use has been frequently described,^6-8 and ACEIs are often underprescribed in patients with CKD because of concerns of hyperkalemia.⁹ β-Blocker (BB) use has also been associated with hyperkalemia, most likely through redistribution of potassium from intracellular to extracellular compartments as a result of blockade of β₂-adrenoreceptor–mediated cellular potassium uptake.^10,11