What risk increases when ACE inhibitors or ARBs are combined with potassium-sparing diuretics?

What risk increases when ACE inhibitors or ARBs are combined with potassium-sparing diuretics?

• A. Hypokalaemia
• B. Hyperkalaemia
• C. Hypotension
• D. Renal failure

Answer: (B)

When ACE inhibitors or ARBs are used, the production or action of angiotensin II drops, which leads to lower aldosterone levels. Aldosterone normally promotes potassium excretion in the kidney; with less aldosterone, potassium isn’t excreted as efficiently. Potassium-sparing diuretics either block the aldosterone receptor or inhibit sodium reabsorption in a way that reduces potassium loss. Together, these effects markedly decrease potassium excretion and allow potassium to accumulate in the blood, causing hyperkalemia. This can be especially risky in patients with kidney impairment or other risk factors.

When ACE inhibitors or ARBs are used, the production or action of angiotensin II drops, which leads to lower aldosterone levels. Aldosterone normally promotes potassium excretion in the kidney; with less aldosterone, potassium isn’t excreted as efficiently. Potassium-sparing diuretics either block the aldosterone receptor or inhibit sodium reabsorption in a way that reduces potassium loss. Together, these effects markedly decrease potassium excretion and allow potassium to accumulate in the blood, causing hyperkalemia. This can be especially risky in patients with kidney impairment or other risk factors.