The comparison of losartan and ramipril on the incidence of hyperkalaemia among hypertensive patients with chronic kidney disease

Authors : Mohammed Salim KT, Saravanakumar RT, Dilip C

Pages : 1-7

Doi:10.26650/IstanbulJPharm.2022.937821

View : 65 | Download : 10

Publication Date : 2022-04-28

Article Type : Research Paper

Abstract :Background and Aims: The Joint National Committee 8th guideline recommends the initiation of renin angiotensin aldoste- rone system insert ignore into journalissuearticles values(RAAS);-linked drugs for hypertensive patients with chronic kidney disease insert ignore into journalissuearticles values(CKD);. Losartan, an angiotensin receptor blocker insert ignore into journalissuearticles values(ARB);, and ramipril, angiotensin converting enzyme insert ignore into journalissuearticles values(ACE); inhibitors, are widely utilized antihypertensive agents with sound efficacy and safety. The study compared the hyperkalemia incidences in CKD patients exposed to losartan and ramipril. Methods: A prospective observational study was conducted for 12 months in the nephrology outpatient setting of a private tertiary care referral hospital in the Malabar region of Kerala. CKD patients with hypertension who were on ACE inhibitors or ARB therapy constituted our study population. Their demographic details, serum creatinine and potassium and urine protein were documented for three consecutive patient consultations. Results: There were an equal number of samples insert ignore into journalissuearticles values(n=186); in each of the losartan and ramipril administered groups. Losar- tan and ramipril doses preferred by the nephrologist were 1.25, 25, 50 & 100 mg and 0.625, 1.2, 2.5, 5 and 10 mg, respec- tively. The Mann-Whitney U test showed statistical significance insert ignore into journalissuearticles values(p0.05); between RAAS-related drugs and patients’ total daily doses. We noticed more frequency of hyperkalemia in the losartan group insert ignore into journalissuearticles values(n=11, 5.9%); than in the ramipril group insert ignore into journalissuearticles values(n=4, 2.2%);. Initially, the mean serum potassium was low in the ACE inhibitor insert ignore into journalissuearticles values(4.35±0.55); subset, and then there was augmenta- tion in the second insert ignore into journalissuearticles values(4.46±0.52); and third insert ignore into journalissuearticles values(4.52±0.55); patient consultations. The repeated measures ANOVA tests depicted the samples to be different insert ignore into journalissuearticles values(p<0.05); in the serum potassium measurements within the losartan group insert ignore into journalissuearticles values(p-=0.018); and ramipril group insert ignore into journalissuearticles values(p<0.001);. Conclusion: Losartan gave favorable clinical effects in CKD patients with regards to serum creatinine and potassium. How- ever, the frequency in reduction of proteinuria was profound in ramipril understudies.
Keywords : Ramipril, Losartan, Hyperkalemia, Serum creatinine, Urine Protein

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