Abstract

There is limited data on the prevalence and risk factors of hyperkalemia in heart failure patients who received spironolactone as an add-on to standard therapy, including angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. The objective of this study is to determine the incidence of hyperkalemia and identify its risk factors among heart failure patients using spironolactone. This retrospective chart review included adult heart failure patients (≥18 y) who were initiated on spironolactone therapy, using health information system data to capture the period from treatment initiation to the incidence of hyperkalemia. The study was conducted at King Abdulaziz Medical City in Riyadh. An excel-based tool (Microsoft® Excel; version 2018) was used for systematic data sampling and analysis. A total of 349 patients met the inclusion criteria. 43 % of patients were men while 57 % were women. The mean age of patients was (64.87±14.02) y. 161 patients were received 12.5 mg spironolactone, 40 % of those patients who had incidence of hyperkalemia. 62 % of those who developed hyperkalemia were on angiotensin-converting enzyme inhibitors, 28 % on angiotensin II receptor blockers, 14 % on potassium supplements. 263 patients were received 25 mg spironolactone, 47 % of patients had incidence of hyperkalemia. 49 % of those who developed hyperkalemia were on angiotensin-converting enzyme inhibitors, 31 % on angiotensin II receptor blockers, and 22 % on potassium supplements. 17 patients were received 50 mg spironolactone, 53 % of patients had incidence of hyperkalemia. Our study showed that half of heart failure patients who used spironolactone developed hyperkalemia and were either on angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Further study with a larger sample size is required to clarify and confirm our study findings.