Abstract | BACKGROUND AND OBJECTIVE: The risk for hyperkalaemia during therapy with angiotensin-converting enzyme inhibitors is especially increased in the elderly diabetic because of a decrease in glomerular filtration rate (GFR), as well as the occurrence of hyporeninaemic hypoaldosteronism. We evaluated the risk for hyperkalaemia under long-term angiotensin-converting enyzme inhibition in 86 insulin-dependent type 2 diabetic patients in relation to their GFR. PATIENTS AND METHODS: We compared the influence of a 3 to 6 months long treatment with angiotensin-converting enzyme inhibitors on the serum potassium levels, the creatinine clearance and the urinary albumin excretion in insulin-dependent type 2 diabetic patients with an initial creatinine clearance < 50 ml/min/1.73m(2) (n = 15, age 66 +/- 6 years) and >/= 50 ml/min/1.73m(2) respectively (n = 71, age 61 +/- 10 years). In addition, we also investigated the influence on the metabolic control and the blood pressure values in both groups of patients. RESULTS: In the patients with creatinine clearance >/= 50 ml/min/1,73m(2) the mean potassium level increased from 4.3 +/- 0.2 to 4.6 +/- 0.4 mmol/l (P < 0,01), while the incidence of a potassium level > 5 mmol/l was 17 %. In the group with a creatinine clearance < 50 ml/min/1.73m(2) the potassium level rose from 4.5 +/- 0.2 to 5.0 +/- 0.4 mmol/l (P < 0.01). The incidence of potassium levels > 5 mmol/l was 66 % (P < 0,01). In both patient groups the creatinine clearances did not change significantly during angiotensin-converting enzyme inhibition, and the urinary albumin excretion as well as the HbA(1c) values and blood pressure showed only a tendency towards a decrease. CONCLUSION:
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Authors | A Raml, B Schmekal, P Grafinger, G Biesenbach |
Journal | Deutsche medizinische Wochenschrift (1946)
(Dtsch Med Wochenschr)
Vol. 126
Issue 47
Pg. 1327-30
(Nov 23 2001)
ISSN: 0012-0472 [Print] Germany |
Vernacular Title | Hyperkaliämierisiko unter Langzeittherapie mit ACE-Hemmern bei insulinpflichtigen Typ-2-Diabetikern in Abhängigkeit von der GFR. |
PMID | 11719857
(Publication Type: English Abstract, Journal Article)
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Chemical References |
- Angiotensin-Converting Enzyme Inhibitors
- Insulin
- Creatinine
- Potassium
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Topics |
- Aged
- Albuminuria
(chemically induced)
- Angiotensin-Converting Enzyme Inhibitors
(adverse effects, therapeutic use)
- Creatinine
(metabolism)
- Diabetes Mellitus, Type 2
(complications, drug therapy)
- Female
- Glomerular Filtration Rate
(drug effects)
- Humans
- Hyperkalemia
(epidemiology, etiology)
- Hypoaldosteronism
(epidemiology, etiology)
- Insulin
(therapeutic use)
- Male
- Middle Aged
- Potassium
(blood)
- Risk Factors
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