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논문KCI 등재

안지오텐신 전환효소 억제제/안지오텐신 수용체 차단제 사용과 고칼륨혈증

Use of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: A Closer Look at Hyperkalemia

박철휘|장유수|정성진
대한내과학회 (The Korean Association Of Internal Medicine)|2011.06|대한내과학회지 (The Korean Journal of Medicine)|제80권 제1호|pp. 20-30

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키워드

레닌-안지오텐신-알도스테론계; 억제제; 고칼륨혈증Renin-angiotensin-aldosterone system; Inhibitor; Hyperkalemia
주제분류내과학

초록

ACEi와 ARB와 같은 RAAS 억제제들은 고혈압, 심혈관 질환, 당뇨병 그리고 만성콩팥병 등에 유용하게 사용되어 왔다. 전반적으로 볼 때 이들 약제 사용과 관련되어 고칼륨혈증이 발생할 수는 있으나, 그 발생 빈도가 높지 않고 환자들이 RAAS 억제를 통하여 얻는 이득이 크므로 RAAS 억제제를 투여 받고 있거나 투여 예정인 환자들에게서는 정기적인 감시를 하면서 처방하는 것이 좋겠다.

Abstract

Therapeutic manipulation of the renin-angiotensin-aldosterone system (RAAS) is an important strategy for improving hypertension,diabetes, cardiovascular disease, and chronic kidney disease. Development of hyperkalemia after the administration of RAAS inhibitors is of particular concern because patients at highest risk for this complication are often the same patients who derive the greatest cardiovascular or renoprotective benefit. Based on an overview of the incidence of hyperkalemia during treatment with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers alone and in combination, this review suggests approaches for monitoring, detecting, and managing hyperkalemia in patients treated with RAAS inhibitors. Although the incidence of hyperkalemia with RAAS inhibitors is generally low, hyperkalemia can be associated with increased mortality. When using RAAS inhibitors, it is important to monitor on-treatment electrolyte levels and renal function parameters in patients with a high risk for hyperkalemia. (Korean J Med 2011;80:20-30)

참고문헌 (40)

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