Korean J Med.  2011 Jan;80(1):20-30.

Use of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: A Closer Look at Hyperkalemia

  • 1Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.


Therapeutic manipulation of the renin-angiotensin-aldosterone system (RAAS) is an important strategy for improving hypertension, diabetes, cardiovascular disease, and chronic kidney disease. Development of hyperkalemia after the administration of RAAS inhibitors is of particular concern because patients at highest risk for this complication are often the same patients who derive the greatest cardiovascular or renoprotective benefit. Based on an overview of the incidence of hyperkalemia during treatment with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers alone and in combination, this review suggests approaches for monitoring, detecting, and managing hyperkalemia in patients treated with RAAS inhibitors. Although the incidence of hyperkalemia with RAAS inhibitors is generally low, hyperkalemia can be associated with increased mortality. When using RAAS inhibitors, it is important to monitor on-treatment electrolyte levels and renal function parameters in patients with a high risk for hyperkalemia.


Renin-angiotensin-aldosterone system; Inhibitor; Hyperkalemia
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