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Original Report: Patient-Oriented, Translational Research

Impact of Renin-Angiotensin Aldosterone System Inhibition on Serum Potassium Levels among Peritoneal Dialysis Patients

Ribeiro S.C.a · Figueiredo A.E.b · Barretti P.c · Pecoits-Filho R.a · de Moraes T.P.a · on behalf of the BRAZPD Investigators

Author affiliations

aPontifícia Universidade Católica do Paraná (PUCPR), Curitiba, bPrograma de Pós-Graduação em Medicina e Ciências da Saúde (Nefrologia), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, and cUNESP, Botucatu, Brazil

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Am J Nephrol 2017;46:150-155

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Article / Publication Details

First-Page Preview
Abstract of Original Report: Patient-Oriented, Translational Research

Received: February 24, 2017
Accepted: June 15, 2017
Published online: July 22, 2017
Issue release date: August 2017

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 3

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: https://www.karger.com/AJN

Abstract

Background: The chronic use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blocker has been associated with hyperkalemia in patients with reduced renal function even after the initiation of hemodialysis. Whether such medications may cause a similar effect in peritoneal dialysis patients is not well established. So, the aim of our study was to analyze the impact of renin-angiotensin-aldosterone inhibitors on the serum levels of potassium in a national cohort of peritoneal dialysis patients. Method: A prospective, observational, nationwide cohort study was conducted. We identified all incident patients on peritoneal dialysis that had angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) prescribed for at least 3 months and a similar period of time without these medications. Patients were divided into 4 groups: Groups I and III correspond to patients using, respectively, an ACEi or ARB and then got the drug suspended; Groups II and IV started peritoneal dialysis without the use of any renin-angiotensin aldosterone system inhibitor and then got, respectively, an ACEi or ARB introduced. Changes in potassium serum levels were compared using 2 statistical approaches: (1) the non-parametric Wilcoxon test for repeated measures and (2) a crossover analysis. Results: Mean potassium serum levels at the first phase of the study for Groups I, II, III, and IV were, respectively, 4.46 ± 0.79, 4.33 ± 0.78, 4.41 ± 0.63, and 4.44 ± 0.56. Changes in mean potassium serum levels for Groups I, II, III, and IV were -0.10 ± 0.60, 0.02 ± 0.56, -0.06 ± 0.46, and 0.03 ± 0.50, respectively. Conclusion: The use of ACEi and ARB was not associated with a greater risk for hyperkalemia in stable peritoneal dialysis patients independently of residual renal function.

© 2017 S. Karger AG, Basel


References

  1. Torlen K, Kalantar-Zadeh K, Molnar MZ, et al: Serum potassium and cause-specific mortality in a large peritoneal dialysis cohort. Clin J Am Soc Nephrol 2012;7:1272-1284.
  2. Ribeiro SC, Figueiredo AE, Barretti P, et al: Low serum potassium levels increase the infectious-caused mortality in peritoneal dialysis patients: a propensity-matched score study. PLoS One 2015;10:e0127453.
  3. Raebel MA: Hyperkalemia associated with use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Cardiovasc Ther 2012;30:e156-e166.
  4. Knoll GA, Sahgal A, Nair RC, et al: Renin-angiotensin system blockade and the risk of hyperkalemia in chronic hemodialysis patients. Am J Med 2002;112:110-114.
  5. Han SW, Won YW, Yi JH, Kim HJ: No impact of hyperkalaemia with renin-angiotensin system blockades in maintenance haemodialysis patients. Nephrol Dial Transplant 2007;22:1150-1155.
  6. Kolesnyk I, Noordzij M, Dekker FW, et al: A positive effect of aII inhibitors on peritoneal membrane function in long-term PD patients. Nephrol Dial Transplant 2009;24:272-277.
  7. Hovind P, Tarnow L, Rossing P, et al: Improved survival in patients obtaining remission of nephrotic range albuminuria in diabetic nephropathy. Kidney Int 2004;66:1180-1186.
  8. Eijkelkamp WB, Zhang Z, Remuzzi G, et al: Albuminuria is a target for renoprotective therapy independent from blood pressure in patients with type 2 diabetic nephropathy: post hoc analysis from the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) trial. J Am Soc Nephrol 2007;18:1540-1546.
  9. Li PK, Chow KM, Wong TY, et al: Effects of an angiotensin-converting enzyme inhibitor on residual renal function in patients receiving peritoneal dialysis. A randomized, controlled study. Ann Intern Med 2003;139:105-112.
  10. Suzuki H, Kanno Y, Sugahara S, et al: Effects of an angiotensin II receptor blocker, valsartan, on residual renal function in patients on CAPD. Am J Kidney Dis 2004;43:1056-1064.
  11. Basturk T, Unsal A, Koc Y, et al: The effects of angiotensin-converting enzyme inhibitors on peritoneal protein loss and solute transport in peritoneal dialysis patients. Clinics (Sao Paulo) 2012;67:877-883.
  12. Kolesnyk I, Dekker FW, Noordzij M, et al: Impact of ACE inhibitors and aII receptor blockers on peritoneal membrane transport characteristics in long-term peritoneal dialysis patients. Perit Dial Int 2007;27:446-453.
    External Resources
  13. Phakdeekitcharoen B, Leelasa-nguan P: Effects of an ACE inhibitor or angiotensin receptor blocker on potassium in CAPD patients. Am J Kidney Dis 2004;44:738-746.
  14. de Moraes TP, Figueiredo AE, de Campos LG, et al: Characterization of the BRAZPD II cohort and description of trends in peritoneal dialysis outcome across time periods. Perit Dial Int 2014;34:714-723.
  15. Loutradis C, Tolika P, Skodra A, et al: Prevalence of hyperkalemia in diabetic and non-diabetic patients with chronic kidney disease: a nested case-control study. Am J Nephrol 2015;42:351-360.
  16. Sandle GI, Gaiger E, Tapster S, Goodship TH: Evidence for large intestinal control of potassium homoeostasis in uraemic patients undergoing long-term dialysis. Clin Sci (Lond) 1987;73:247-252.

Article / Publication Details

First-Page Preview
Abstract of Original Report: Patient-Oriented, Translational Research

Received: February 24, 2017
Accepted: June 15, 2017
Published online: July 22, 2017
Issue release date: August 2017

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 3

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: https://www.karger.com/AJN


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