Does the increased prescription of spironolactone following the publication of RALES affect rates of hyperkalemia-associated morbidity and mortality?
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.
Juurlink et al. (2004) studied this question.