Female Preponderance in Diuretic‐associated Hypokalemia

Clark, Beverly G.; Wheatley, Robert E.; Rawlings, John L.; Vestal, Robert E.

doi:10.1111/j.1532-5415.1982.tb05620.x

Cited by 13 publications

(3 citation statements)

References 18 publications

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“…These results confirm previous reports (Clark et al, 1982;Krakauer & Lauritzen, 1978;Morgan, 1981) that women are more likely than men to have hypokalaemia when treated with diuretics, but in addition show that this phenomenon is not confined to elderly patients and, unlike earlier studies, cannot be explained by differences, between the sexes, in the type and dose of diuretic, the concurrent use of other antihypertensive drugs, and the presence of heart failure. Serum potassium (mmol/1) Figure 1 Distribution of serum potassium in 102 women (O) and 91 men (Li) taking bendrofluazide 5 mg daily for hypertension.…”

Section: Discussionsupporting

confidence: 91%

“…It has recently been reported that hypokalaemia may not be a significant problem in men taking diuretics (Clark et al, 1982;Krakauer & Lauritzen, 1978;Morgan, 1981) and suggested that monitoring of serum potassium and the use of prophylaxis against hypokalaemia need only be considered for women (Morgan, 1981). However, the three studies cited involved only elderly patients and failed to take sufficient account of those factors known to affect serum potassium, including the use of potassium supplements and potassium sparing drugs.…”

Section: Introductionmentioning

confidence: 99%

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Thiazide‐induced hypokalaemia; prevalence higher in women.

Toner¹,

Ramsay²

1984

Brit J Clinical Pharma

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In 193 hypertensive patients taking bendrofluazide 5 mg daily, the mean serum potassium concentration was lower in women than in men (3.77 vs 3.99 mmolll, P < 0.001) and the prevalence of hypokalaemia (< 3.5 mmol/l) was higher (25% vs 12%, P < 0.05). This difference between the sexes was independent of age, body weight, renal function, the use of other antihypertensive drugs and compliance with treatment as judged by tablet counts. Severe hypokalaemia (< 3.0 mmol/l) was uncommon and showed no difference between the sexes.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Thiazide‐induced hypokalaemia; prevalence higher in women.

Toner¹,

Ramsay²

1984

Brit J Clinical Pharma

View full text Add to dashboard Cite

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“…Lower plasma potassium concentrations in women compared to men have been reported in previous human and animal studies 64-66 and attributed to estrogen effects, enhancing the action of mineralcorticoids on the kidney and increasing β 2 adrenoreceptor density, affinity or G protein coupling to adenylate cyclase in skeletal muscle and red blood cells thus causing an intracellular influx of potassium into the cells. 66, 67 …”

Section: Discussionmentioning

confidence: 73%

Analysis of baseline parameters in the HALT polycystic kidney disease trials

Torres

Chapman

Perrone

et al. 2012

Kidney International

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HALT-PKD consists of two randomized trials comparing treatment with an angiotensin converting inhibitor (ACEI)-angiotensin receptor blocker (ARB) combination vs ACEI alone and standard vs low blood pressure target in Study A (eGFR >60 ml/min/1.73 m2) and ACEI-ARB vs ACEI alone in Study B (eGFR 25-60 ml/min/1.73 m2). It includes the largest cohort of systematically studied ADPKD patients (558 A and 486 B) to date. We used correlation and multiple regression cross-sectional analyses to ascertain associations of baseline parameters with total kidney (TKV) and liver (TLV) or liver cyst (LCV) volumes measured by MRI in Study A and with eGFR in both studies. Lower eGFR and higher natural log transformed urine albumin excretion are independently associated with larger natural log transformed TKV adjusted for height (HtTKV). Higher BSA is independently associated with higher ln(HtTKV) and lower eGFR. Men have larger HtTKV and smaller LCV than women. A weak correlation was found between ln(HtTKV) and ln(HtTLV) or ln(LCV) in women only. Women have higher urine aldosterone excretions and lower plasma potassium levels. In summary, this analysis 1) confirms a strong association between renal volume and functional parameters, 2) shows that gender and other factors differentially affect the development of polycystic disease in the kidney and liver, and 3) suggests an association between anthropomorphic measures reflecting preand/or post-natal growth and the severity of the disease.

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A case of hypokalemia-induced fatal arrhythmia caused by indapamide in an anorexic elderly patient

et al. 2011

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An 84-year-old man was referred to our hospital for atrioventricular block and severe hypokalemia. He had been treated for hypertension since 2007 with indapamide, a thiazide-like diuretic. His laboratory data had not been tested for a long time. One week before his first visit, he suffered from a common cold and anorexia. He was admitted to our hospital because his electrocardiogram showed ventricular flutter, and pulmonary arrest occurred at the time of his visit. Cardiopulmonary resuscitation was successfully performed. Hypokalemia (K, 1.7 mEq/L) was considered as the cause of acute cardiopulmonary failure. His oral intake of potassium decreased, but potassium loss from the kidney persisted (urinary potassium, 14.0 mEq/L; transtubular potassium gradient, 5.00). These results suggested that although hypokalemia was suspected to have been present for a long time due to indapamide, severe hypokalemia was induced during the period of anorexia. After discontinuation of indapamide and intravenous administration of potassium L: -aspartate for potassium supplementation, the patient's serum potassium levels increased and his general condition improved. Although it is well known that hypokalemia is caused by indapamide, the incidence is not frequent and if observed is not severe. However, we experienced an unusual case of hypokalemia-induced fatal arrhythmia caused by indapamide. Hence, the serum potassium concentration of patients under the drug, especially anorexic elderly patients, should be monitored.

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Female Preponderance in Diuretic‐associated Hypokalemia

Cited by 13 publications

References 18 publications

Thiazide‐induced hypokalaemia; prevalence higher in women.

Thiazide‐induced hypokalaemia; prevalence higher in women.

Analysis of baseline parameters in the HALT polycystic kidney disease trials

A case of hypokalemia-induced fatal arrhythmia caused by indapamide in an anorexic elderly patient

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