PMID- 23801997
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130627
LR  - 20240514
IS  - 1664-3828 (Print)
IS  - 1664-5502 (Electronic)
IS  - 1664-5502 (Linking)
VI  - 3
IP  - 1
DP  - 2013 Apr
TI  - Increased Spironolactone in Advanced Heart Failure: Effect of Doses Greater than 
      25 mg/Day on Plasma Potassium Concentration.
PG  - 1-6
LID - 10.1159/000346447 [doi]
AB  - BACKGROUND: Daily doses of spironolactone higher than 25 mg are rarely used in 
      heart failure (HF) patients, presumably due to the concern for hyperkalemia. 
      However, in advanced HF, doses >/=50 mg have been found to be necessary to produce 
      natriuresis. The aim of the present study was to examine the safety of 
      natriuretic doses of spironolactone (50-200 mg) on serum potassium concentration 
      in New York Heart Association (NYHA) class III/IV HF patients over several weeks. 
      METHODS: 18 patients with advanced HF received 50-200 mg of spironolactone in 
      addition to standard treatment. Serum electrolytes, BUN and serum creatinine were 
      assessed at baseline, during increased doses of spironolactone and at the 1-month 
      follow-up. RESULTS: During a total of 738 patient-weeks, there was no significant 
      increase in mean serum potassium (4.0 vs. 4.2 mEq/l) or serum creatinine (1.3 vs. 
      1.4 mg/dl). However, in 3 patients, spironolactone treatment was stopped due to a 
      mean increase in serum creatinine (1.9 vs. 2.6 mg/dl) and in one of them, an 
      increase in serum potassium (4.4 vs. 5.2 mEq/l) was noted. CONCLUSION: Increased 
      doses of spironolactone are generally safe during outpatient follow-up in 
      selected patients with advanced HF, who are receiving treatment with ACE 
      inhibitors, beta-blockers, and loop diuretics.
FAU - Shchekochikhin, Dmitry
AU  - Shchekochikhin D
FAU - Lindenfeld, JoAnn
AU  - Lindenfeld J
FAU - Schrier, Robert
AU  - Schrier R
LA  - eng
PT  - Journal Article
DEP - 20130130
PL  - Switzerland
TA  - Cardiorenal Med
JT  - Cardiorenal medicine
JID - 101554863
PMC - PMC3678142
OTO - NOTNLM
OT  - Heart failure
OT  - Hyperkalemia
OT  - Spironolactone
EDAT- 2013/06/27 06:00
MHDA- 2013/06/27 06:01
PMCR- 2013/01/30
CRDT- 2013/06/27 06:00
PHST- 2012/09/14 00:00 [received]
PHST- 2012/12/07 00:00 [accepted]
PHST- 2013/06/27 06:00 [entrez]
PHST- 2013/06/27 06:00 [pubmed]
PHST- 2013/06/27 06:01 [medline]
PHST- 2013/01/30 00:00 [pmc-release]
AID - 000346447 [pii]
AID - crm-0003-0001 [pii]
AID - 10.1159/000346447 [doi]
PST - ppublish
SO  - Cardiorenal Med. 2013 Apr;3(1):1-6. doi: 10.1159/000346447. Epub 2013 Jan 30.