Which medication class is commonly associated with hyperkalemia?

Which medication class is commonly associated with hyperkalemia?

• A. Cyclosporine
• B. Loop diuretics
• C. ACE inhibitors
• D. Beta blockers

Answer: (C)

Medications that raise potassium levels do so mainly by reducing the kidney’s ability to excrete potassium, often through suppression of aldosterone. ACE inhibitors block the formation of angiotensin II, which lowers aldosterone secretion from the adrenal glands. With less aldosterone, the distal nephron and collecting ducts reabsorb less potassium and secrete less potassium into the urine, leading to accumulation of potassium in the blood. This risk is amplified in people with kidney dysfunction or when other potassium-sparing drugs or NSAIDs are used. For comparison, loop diuretics increase potassium loss and typically cause hypokalemia, while beta blockers can cause mild hyperkalemia in some scenarios and cyclosporine can contribute to hyperkalemia through nephrotoxicity, but the most common and classic association is with ACE inhibitors.

Medications that raise potassium levels do so mainly by reducing the kidney’s ability to excrete potassium, often through suppression of aldosterone. ACE inhibitors block the formation of angiotensin II, which lowers aldosterone secretion from the adrenal glands. With less aldosterone, the distal nephron and collecting ducts reabsorb less potassium and secrete less potassium into the urine, leading to accumulation of potassium in the blood. This risk is amplified in people with kidney dysfunction or when other potassium-sparing drugs or NSAIDs are used. For comparison, loop diuretics increase potassium loss and typically cause hypokalemia, while beta blockers can cause mild hyperkalemia in some scenarios and cyclosporine can contribute to hyperkalemia through nephrotoxicity, but the most common and classic association is with ACE inhibitors.