Moderate
Established
विवरण
ARBs combined with spironolactone substantially increase hyperkalemia risk through additive suppression of renal potassium excretion.
तंत्र
ARBs reduce angiotensin II–stimulated aldosterone release; spironolactone blocks aldosterone receptors. Together they markedly reduce distal tubular potassium secretion.
नैदानिक महत्व
Hyperkalemia can cause dangerous cardiac arrhythmias; risk is amplified in patients with renal impairment, diabetes, or concurrent potassium supplementation.
प्रबंधन
Monitor potassium and creatinine at baseline, 1 week, 1 month, and every 3–6 months; hold combination if potassium exceeds 5.0–5.5 mEq/L; avoid in CKD stage 4–5.