Prescription of renin-angiotensin system blockers and risk of hyperkalemia in patients with diabetes mellitus: retrospective study

The development of hyperkalemia is thought to be significantly associated with the use of ACE inhibitors andARBs. A retrospective observational cohort study conducted was conducted with200 in patients among the study subjects of the age group of 18 years and above. Majority of the cases were males (50.5%) than females (49.5%). Average serum potassium of non-exposed group was found to be 3.9±0.36 mEq/L and exposed group was found to be 4.1±0.5 mEq/L. Average baseline creatinine(mg/dL) of non-exposed group was 1±0.82 mg/dL and exposed group was 0.96 ±0.2 mg/dL. ACEIs were administrated to 1% of the patients (1/100) and ARBs to 99% (99/100). Incidences of hyperkalemia were the highest with the use of losartan (0.92%,2/13), olmesartan (0.85%, 2/14) followed by telmisartan (0.64%, 7/65 persons). The causality assessment of reported ADRs as per the Naranjo scale revealed that 67% were probable, 33% were definite, 0% were possible and unlikely. The Hartwig severity scale showed that all were of mild type and according to the modified Schumock and Thornton scale all were probably preventable there was a significant association between Hyperkalemia and administration of ARBS/ACE –inhibitors (χ2= 11.640, df= 2, p<0.01).