Diuretic-induced hypokalaemia: an updated review.
Ziying LinLouisa Y F WongBernard Man Yung CheungPublished in: Postgraduate medical journal (2021)
Diuretic-induced hypokalaemia is a common and potentially life-threatening adverse drug reaction in clinical practice. Previous studies revealed a prevalence of 7%-56% of hypokalaemia in patients taking thiazide diuretics. The clinical manifestations of hypokalaemia due to diuretics are non-specific, varying from asymptomatic to fatal arrhythmia. Diagnosis of hypokalaemia is based on the level of serum potassium. ECG is useful in identifying the more severe consequences. A high dosage of diuretics and concomitant use of other drugs that increase the risk of potassium depletion or cardiac arrhythmias can increase the risk of cardiovascular events and mortality. Thiazide-induced potassium depletion may cause dysglycaemia. The risk of thiazide-induced hypokalaemia is higher in women and in black people. Reducing diuretic dose and potassium supplementation are the most direct and effective therapies for hypokalaemia. Combining with a potassium-sparing diuretic or blocker of the renin-angiotensin system also reduces the risk of hypokalaemia. Lowering salt intake and increasing intake of vegetables and fruits help to reduce blood pressure as well as prevent hypokalaemia.
Keyphrases
- cardiovascular events
- high glucose
- drug induced
- blood pressure
- diabetic rats
- adverse drug
- clinical practice
- end stage renal disease
- coronary artery disease
- risk factors
- cardiovascular disease
- heart rate
- emergency department
- left ventricular
- chronic kidney disease
- heart failure
- metabolic syndrome
- acute heart failure
- pregnant women
- electronic health record
- heart rate variability
- climate change
- insulin resistance
- single cell
- heavy metals
- skeletal muscle
- angiotensin ii
- pregnancy outcomes