期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 68, 期 14, 页码 1575-1589出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2016.06.060
关键词
angiotensin-converting enzyme inhibitors; angiotensin-receptor blockers; chronic kidney disease; mineralocorticoid receptor antagonist; patiromer; sodium zirconium cyclosilicate
资金
- Forest Laboratories
- National Institutes of Health
- Novartis
- European Union
Disorders of potassium homeostasis can potentiate the already elevated risk of arrhythmia in heart failure. Heart failure patients have a high prevalence of chronic kidney disease, which further heightens the risk of hyperkalemia, especially when renin-angiotensin-aldosterone system inhibitors are used. Acute treatment for hyperkalemia may not be tolerated in the long term. Recent data for patiromer and sodium zirconium cyclosilicate, used to treat and prevent high serum potassium levels on a more chronic basis, have sparked interest in the treatment of hyperkalemia, as well as the potential use of renin-angiotensin-aldosterone system inhibitors in patients who were previously unable to take these drugs or tolerated only low doses. This review discusses the epidemiology, pathophysiology, and outcomes of hyperkalemia in heart failure; provides an overview of traditional and novel ways to approach management of hyperkalemia; and discusses the need for further research to optimally treat heart failure. (C) 2016 by the American College of Cardiology Foundation.
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