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[1] [2] Hyperkalemia can cause an abnormal heart rhythm which can result in cardiac arrest and death. [1] [3] Common causes of hyperkalemia include kidney failure, hypoaldosteronism, and rhabdomyolysis. [1] A number of medications can also cause high blood potassium including spironolactone, NSAIDs, and angiotensin converting enzyme inhibitors. [1]
As potassium levels get higher, individuals may begin to experience nausea, vomiting, and diarrhea. [3] Patients with severe hyperkalemia, defined by levels above 7 mEq/L, may experience muscle cramps, numbness, tingling, absence of reflexes, and paralysis. [3] [14] Patients may experience arrhythmias that can result in death. [3] [14]
Candesartan is an angiotensin receptor blocker used mainly for the treatment of high blood pressure and congestive heart failure. Candesartan has a very low maintenance dose . Like olmesartan , the metabolism of the drug is unusual as it is a cascading prodrug .
Common adverse effects [>1%] include hyperkalaemia [high potassium levels in the blood, a known side effect of Valsartan], hypotension [low blood pressure, common in vasodilators and extracellular fluid volume reducers], a persistent dry cough and renal impairment [reduced kidney function]. [21] [19] [22]
Hypoaldosteronism may result in high blood potassium and is the cause of 'type 4 renal tubular acidosis', sometimes referred to as hyperkalemic RTA or tubular hyperkalemia. However, the acidosis, if present, is often mild. It can also cause urinary sodium wasting, leading to volume depletion and hypotension. [citation needed]
High potassium levels can be life-threatening, and respond to increased urine production and renal replacement therapy (see below). [12] Temporary measures include the administration of calcium to protect against cardiac complications, insulin or salbutamol to redistribute potassium into cells, and infusions of bicarbonate solution.
Treatment includes removing the causative agent (such as licorice), a high-potassium, low-sodium diet (for primary) and high-sodium diet (for secondary), spironolactone and eplerenone, potassium-sparing diuretics that act as aldosterone antagonists, and surgery, depending on the cause. [11] For adrenal adenoma, sometimes surgery is performed.
Many patients experience fatigue, potassium deficiency and high blood pressure which may cause poor vision, confusion or headaches. [1] [2] Symptoms may also include: muscular aches and weakness, muscle spasms, low back and flank pain from the kidneys, trembling, tingling sensations, dizziness/vertigo, nocturia and excessive urination. [1]