Risk factors for hyperkalemia in cirrhotic patients receiving spironolactone.

  • Tahir Ullah Khan Shalamar Hospital, Lahore.
  • Sajjad Iqbal Shalamar Hospital, Lahore.
  • Muhammad Haroon Yousuf Shalamar Hospital, Lahore.
  • Naseer Nazeer Memon Social Security Hospital, Lahore.
  • Sajid Iqbal Shaikh Zayed Hospital, Lahore.
Keywords: Cirrhosis, Hyperkalemia, Spironolactone

Abstract

Objectives: To determine the factors those may predict hyperkalemia in cirrhotic patients receiving spironolactone. Study Design: Cross sectional descriptive study. Setting: Medicine Department Shalamar Hospital, Lahore. Period: 15 days from 1st September to 15th September 2017. Materials & Methods: 150 patients with documented liver cirrhosis, receiving spironolactone and fulfilling the inclusion criteria were made part of the study. Five mL blood was drawn in two different vials; 2 mL in EDTA vial to check the prothrombin time (PT) and 3 mL in clotted vial to measure serum potassium, sodium, creatinine, urea, albumin, and bilirubin in serum after centrifugation. Potassium level was measured at baseline (Day-0) and two weeks later after receiving spironolactone. Results: Patients with raised serum creatinine (>1.3 mg/dL) and hyperbilirubinemia (>2.8 mg/dL) were found to have serum potassium more than 5 mmol/L. Increased potassium levels were found in patients receiving high dosage of spironolactone (>100mg/day). These patients had decompensated liver cirrhosis as evident from their child-class C and significant hypoalbuminemia. Conclusion: Decompensated cirrhotic patients with raised serum creatinine, hyperbilirubinemia, hypoalbuminemia and receiving high dosage of spironolactone remain at higher risk of developing hyperkalemia.

Author Biographies

Tahir Ullah Khan, Shalamar Hospital, Lahore.

MBBS, FCPS (Medicine)

Senior Registration Medicine

 

Sajjad Iqbal, Shalamar Hospital, Lahore.

PhD (Biochemistry)

Consultant in Pathology

 

Muhammad Haroon Yousuf, Shalamar Hospital, Lahore.

MBBS, FCPS (Medicine)

Professor and Head Medicine

 

Naseer Nazeer Memon, Social Security Hospital, Lahore.

MBBS

Medical Officer

 

Sajid Iqbal, Shaikh Zayed Hospital, Lahore.

MBBS

Medical Officer Pediatric

Published
2020-02-10