Document Detail

Hyperkalemia in the elderly: drugs exacerbate impaired potassium homeostasis.
MedLine Citation:
PMID:  9346463     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To review the pathophysiology underlying the predisposition to hyperkalemia in the elderly; the medications that disrupt potassium balance and promote the development of hyperkalemia in the elderly; the prevention of hyperkalemia in elderly patients treated with potassium-altering medications; and the appropriate management of hyperkalemia when it develops. METHODS AND MAIN RESULTS: A MEDLINE search of the literature (1966-1996) using the terms hyperkalemia, drugs, elderly, and treatment was conducted and pertinent review articles, textbooks, and personal files were consulted. Elderly subjects appear to be predisposed to the development of hyperkalemia on the basis of both innate disturbances in potassium homeostasis and comorbid disease processes that impair potassium handling. Hyperkalemia in the elderly is most often precipitated by medications that impair cellular uptake or renal disposal of potassium. This electrolyte disorder is best prevented by recognition of at-risk physiology in the aged, avoidance of therapy with certain high-risk medications, and monitoring of plasma potassium concentration and renal function at intervals appropriate for the medication prescribed. Management of hyperkalemia entails identification of the clinical manifestations of severe hyperkalemia, stabilization of cardiac tissue, promotion of cellular potassium uptake, and ultimately removal of potassium from the body. CONCLUSIONS: Geriatric patients should be considered at risk of developing hyperkalemia, especially when they are prescribed certain medications. Potassium levels should be monitored at appropriate intervals when these patients are treated with potassium-altering medications. Appropriate management of hyperkalemia in the elderly can avoid life-threatening neuromuscular and cardiac complications.
M A Perazella; R L Mahnensmith
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of general internal medicine     Volume:  12     ISSN:  0884-8734     ISO Abbreviation:  J Gen Intern Med     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-11-21     Completed Date:  1997-11-21     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8605834     Medline TA:  J Gen Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  646-56     Citation Subset:  IM    
Department of Medicine, Yale University School of Medicine, New Haven, Conn. 06520-8029, USA.
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MeSH Terms
Homeostasis / drug effects*
Hyperkalemia / epidemiology,  etiology*,  physiopathology,  therapy*
Hypoaldosteronism / chemically induced
Pharmaceutical Preparations / adverse effects*
Potassium / metabolism
Risk Factors
Reg. No./Substance:
0/Pharmaceutical Preparations; 7440-09-7/Potassium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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