Management of Hyperkalemia in Heart Failure [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2021; 49(1): 1-32 | DOI: 10.5543/tkda.2021.S1

Management of Hyperkalemia in Heart Failure

Hakan Altay1, Yüksel Çavuşoğlu2, Ahmet Çelik3, Şerafettin Demir4, Barış Kılıçarslan5, Sanem Nalbantgil6, Ahmet Temizhan7, Bülent Tokgöz8, Dilek Ural9, Dilek Yeşilbursa10, Özlem Yıldırımtürk11, Mehmet Birhan Yılmaz12
1Başkent Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İstanbul, Türkiye
2Eskişehir Osmangazi Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Eskişehir, Türkiye
3Mersin Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Mersin, Türkiye
4Adana Devlet Hastanesi, Kardiyoloji Kliniği, Adana, Türkiye
5Tepecik Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, İzmir, Türkiye
6Ege Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İzmir, Türkiye
7Sağlık Bilimleri Üniversitesi, Ankara Şehir Hastanesi, Kardiyoloji Anabilim Dalı, Ankara, Türkiye
8Erciyes Üniversitesi Tıp Fakültesi, Nefroloji Bilim Dalı, Kayseri, Türkiye
9Koç Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İstanbul, Türkiye
10Uludağ Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Bursa, Türkiye
11Sağlık Bilimleri Üniversitesi, Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kardiyoloji Bölümü, İstanbul, Türkiye
12Dokuz Eylül Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İzmir, Türkiye

Hyperkalemia is a common electrolyte abnormality in heart failure (HF) that can cause potentially life-threatening cardiac arrhythmias and sudden cardiac death. HF patients with diabetes, chronic kidney disease and older age are at higher risk of hyperkalemia. Moreover, hyperkalemia is also often associated with the use of renin-angiotensin-aldosterone system inhibitors (RAASi) including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists and sacubitril-valsartan. In clinical practice, the occurrence of hyperkalemia is a major concern among the clinicians and often limits RAASi use and/or lead to dose reduction or discontinuation, thereby reducing their potential benefits for HF. Furthermore, recurrent hyperkalemia is frequent in the long-term and is associated with an increase in hyperkalemia-related hospitalizations. Therefore, management of hyperkalemia has a special importance in HF patients. However, treatment options in chronic management are currently limited. Dietary restriction of potassium is usually ineffective with variable adherence. Sodium polystyrene sulfonate is commonly used, but its effectiveness is uncertain and reported to be associated with intestinal toxicity. New therapeutic options such as potassium binders have been suggested as potentially beneficial agents in the management of hyperkalemia. This document discusses prevalence, predictors and management of hyperkalemia in HF, emphasizing the importance of careful patient selection for medical treatment, uptitration of the doses of RAASi, regular surveillance of potassium and treatment options of hyperkalemia.

Keywords: Heart failure, Hyperkalemia, Management, Treatment

How to cite this article
Hakan Altay, Yüksel Çavuşoğlu, Ahmet Çelik, Şerafettin Demir, Barış Kılıçarslan, Sanem Nalbantgil, Ahmet Temizhan, Bülent Tokgöz, Dilek Ural, Dilek Yeşilbursa, Özlem Yıldırımtürk, Mehmet Birhan Yılmaz. Management of Hyperkalemia in Heart Failure. Turk Kardiyol Dern Ars. 2021; 49(1): 1-32

Corresponding Author: Hakan Altay, Türkiye
Manuscript Language: English
© Copyright 2021 Archives of the Turkish Society of Cardiology
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