Does the increased prescription of spironolactone following the publication of RALES affect rates of hyperkalemia-associated morbidity and mortality?
Patients following the publication of the Randomized Aldactone Evaluation Study (RALES)
Spironolactone
Rate of prescriptions for spironolactone and hyperkalemia-associated morbidity and mortalitysafety
The publication of the RALES trial led to increased spironolactone prescriptions, which was associated with a real-world rise in hyperkalemia-related morbidity and mortality, highlighting the need for closer laboratory monitoring.
The publication of RALES was associated with abrupt increases in the rate of prescriptions for spironolactone and in hyperkalemia-associated morbidity and mortality. Closer laboratory monitoring and more judicious use of spironolactone may reduce the occurrence of this complication.
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David N. Juurlink
Muhammad Mamdani
Douglas S. Lee
New England Journal of Medicine
University of Toronto
Institute for Clinical Evaluative Sciences
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Juurlink et al. (Wed,) studied this question.
www.synapsesocial.com/papers/69d861fdc025a7c015bedc39 — DOI: https://doi.org/10.1056/nejmoa040135