Spironolactone and amiloride increased levels of renin, angiotensin II, and aldosterone compared to Slow K, with higher plasma potassium but similar exchangeable potassium.
Do potassium-sparing diuretics (spironolactone, amiloride) compared to potassium supplementation alter the renin-angiotensin-aldosterone system and potassium retention in patients with heart failure?
In heart failure patients, replacing potassium supplementation with potassium-sparing diuretics (spironolactone or amiloride) increases RAAS activation without significantly altering total exchangeable potassium.
The renin-angiotensin-aldosterone system and electrolyte levels in 11 patients with heart failure controlled on digoxin and frusemide were investigated after separate periods of Slow K, spironolactone, and amiloride therapy. When spironolactone or amiloride replaced Slow K, distinct parallel increments in the levels of renin, angiotensin II, and aldosterone resulted. Though plasma potassium was generally higher after spironolactone and amiloride than after Slow K, exchangeable potassium was similar with the three regimens. There was no significant relation between plasma potassium and concurrent exchangeable potassium.
Nicholls et al. (Fri,) conducted a other in Heart failure (n=11). Spironolactone and amiloride vs. Slow K was evaluated on Renin-angiotensin-aldosterone system and electrolyte levels. Spironolactone and amiloride increased levels of renin, angiotensin II, and aldosterone compared to Slow K, with higher plasma potassium but similar exchangeable potassium.
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