慢性腎不全患者にカンデサルタンシレキセチルを投与し高カリウム血症を来たした1例

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A71-year-old woman had been treated for chronic renal failure (CRF), hypertension and chronic bronchitis at a local clinic since 1999. Her blood pressure had been successfully controlled by arotinolol hydrochloride. In May 2000, however, her blood pressure became poorly controlled and subsequently, the administration of 8 mg/day of candesartan cilexetil was started but proved to be ineffective. As a result, her blood pressure further increased to 200/140mmHg while the serum potassium (K) Ievel reached 7.5mEq/L. She was then hospitalized in our department. Calcium polystyrene sulfonate (CPS) was started in place of candesartan cilexetil for the treatment of hyperkalemia. Her serum K level decreased to 3.0.mEq/L after 1 week with stabilized values of around 3.6mEq/L even after the withdrawal of CPS. Probably due to her basic disease of CRF, urea nitrogen (BUN) increased to 72.7mg/dL, serum creatinine (Scr) to 3.60mg/dL and K to 7.6mEq/L 2 months after the initiation of candesartan cilexetil. Since her renal function recovered after the withdrawal of this drug and the serum K levels decreased to within the normal range, an acute exacerbation of CRF complicated with hyperkalemia due to candesartan cilexetil was finally diagnosed. When an angiotensin 11 receptor antagonist is administered in patients with renal failure, doctors should carefully monitor for possible changes in the BUN and Scr in addition to a closely observing the serum K levels.
日本医療薬学会の論文
2001-02-10

慢性腎不全患者にカンデサルタンシレキセチルを投与し高カリウム血症を来たした1例

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