How is mild renal insufficiency and hypokalemia (low potassium level) managed?

Updated: Dec 06, 2018
  • Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Often, individuals with cirrhosis or chronic heart failure have subtle decreases in renal function that may not be apparent from routine laboratory studies. In addition, patients with heart failure often are treated with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), classes of drugs that inhibit renal potassium excretion.

In patients with mild renal insufficiency, the combination of an ACE inhibitor, a potassium-sparing diuretic, and a potassium supplement can very easily result in life-threatening hyperkalemia. Frequent follow-up is necessary to avoid this outcome.

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