Effect of Long-Term Diuretic Treatment on Body-Potassium in Heart-Disease

Davidson, Christopher; McLachlan, M. S. F.; Burkinshaw, L.; Morgan, Diane

doi:10.1016/s0140-6736(76)90965-x

Cited by 49 publications

(28 citation statements)

References 23 publications

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“…The necessity for potassium supplementation in patients on diuretic therapy has been questioned by some investigators (Davidson et al 1976, Kassirer & Harrington 1977 Letter on Drugs and Therapeutics 1981). However, the diets of elderly patients are often lacking in foods high in potassium (Judge 1972, Davies et al 1973, British Medical Journal 1978, Lancet 1974) and the importance -of preventing hypokalaemia -particularly in patients taking digitalis, who often already have reduced body potassium because of their heart failure (Flear 1969, Nagant de Deux Chaisnes & Mach 1974, Cohen 1979)-is well recognized (Dyckner et al 1975, Spector 1972, Lant 1977, British Medical Journal 1977, McCarthy 1983.…”

Section: Discussionmentioning

confidence: 99%

Effects on Upper Gastrointestinal Mucosa of Three Delivery Systems of Potassium as Supplement to Frusemide Administration

McLoughlin¹

1985

J R Soc Med

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Summary: Thirty healthy volunteers were recruited into a study to determine the effects on the gastrointestinal mucosa of 3 different delivery systems of oral potassium supplementation associated with diuretic therapy (Diumide-K ContinusR tablets, Napp; Lasikal tablets, Hoechst; Lasix and Slow-KR tablets, Hoechst, Ciba). The volunteers *were gastroscoped initially and after one week of treatment with one of the three therapies. There was a '60% incidence of erosions in the Lasix + Slow-K group, a 40% incidence in the Lasikal group, but no erosions in the group receiving Diumide-K Continus tablets. It is therefore concluded that Diumide-K Continus tablets incorporate the potassium in a delivery system which is unlikely to cause disruption to the gatrointestinal mucosa.

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Section: Discussionmentioning

confidence: 99%

Effects on Upper Gastrointestinal Mucosa of Three Delivery Systems of Potassium as Supplement to Frusemide Administration

McLoughlin¹

1985

J R Soc Med

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“…Where body potassium has been estimated from measurements of total exchangeable potassium, it has been suggested that body potassium is significantly reduced (Davidson and Gillebrand, 1973;Nicholls et al, 1976;British Medical Journal, 1977). However, where whole body potassium has been measured by whole body counting, little or no deficit has been found (Delwaide and Rorive, 1973;Davidson et al, 1976;Lawson et al, 1976). The present study confirms that, for patients with cardiac failure, the quantification ofthe degree ofpotassium depletion by measuring total exchangeable potassium may well exaggerate the degree of depletion, and caution should be exercised in basing any treatment regimen on such tests.…”

Section: Discussionmentioning

confidence: 99%

“…Only three studies have so far been reported in which the total body potassium of patients in cardiac failure has been measured by counting 40K in a whole body counter. The deficits of body potassium content were reported as being 10 per cent by Delwaide and Rorive (1973); 5 per cent by Davidson et al (1976); and Lawson et al (1976) found no significant deficit. The discrepancy in the findings using the two methods may in part be accounted for by the problem of delayed equilibration in the measurement of exchangeable potassium.…”

mentioning

confidence: 96%

Whole body potassium and total exchangeable potassium in elderly patients with cardiac-failure.

Lye¹,

Winston²

1979

Heart

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Body potassium status of patients with cardiac failure may be estimated by a number of methods, but increasing reliance is being placed upon radioisotope dilution with 42K which measures the total exchangeable potassium. Total exchangeable potassium comprises between 86 per cent and 97 per cent of whole body potassium in healthy subjects. We have measured total exchangeable potassium in 22 oedema-free elderly patients with stable cardiac failure and compared the results with simultaneously determined measurements of whole body potassium obtained by whole body counting. The mean whole body potassium was 2360 +/- 640 mmol. The mean value of total exchangeable potassium measured at 24 hours was 1820 +/- 610 mmol (77% of whole body potassium) and increased further to 2000 +/- 600 mmol (84%) when measured after 48 hours. In patients with cardiac failure and, perhaps, also other patients with a history of fluid retention, the mixing of a tracer dose may be significantly delayed, which if not appreciated may lead to an overestimate of potassium depletion.

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“…Hypokalemia is a frequent and feared side effect of the treatment of HF with loop diuretics and digoxin [23] because the arrhythmogenic potential of digoxin is enhanced by hypokalemia. The main classes of diuretics are the loop diuretics, K + -sparing diuretics, and thiazides.…”

Section: Etiology and Pathophysiology Of Hypokalemia In Hfmentioning

confidence: 99%

“…The main classes of diuretics are the loop diuretics, K + -sparing diuretics, and thiazides. Loop diuretics, the mainstay of acute and chronic therapy for HF, are "threshold drugs"; therefore, a dose adequate to achieve a pharmacodynamic effect must be prescribed [23].…”

Section: Etiology and Pathophysiology Of Hypokalemia In Hfmentioning

confidence: 99%