Which medication is commonly associated with hyperkalemia?

Which medication is commonly associated with hyperkalemia?

• A. Cyclosporine
• B. ACE inhibitors
• C. Furosemide
• D. Thiazide

Answer: (A)

The main idea here is how certain drugs disturb kidney potassium handling to raise serum potassium. Cyclosporine, a calcineurin inhibitor often used in transplant patients, is well known for causing hyperkalemia. It narrows the afferent arteriole, which lowers renal blood flow and glomerular filtration rate. With a lower GFR, less potassium is filtered and excreted, and the distal nephron’s ability to secrete potassium can also be impaired. Additionally, there may be a tubular dysfunction and blunted aldosterone response, further reducing potassium disposal. In contrast, diuretics like furosemide and thiazides promote potassium loss and typically cause hypokalemia, not hyperkalemia. ACE inhibitors can cause hyperkalemia by reducing aldosterone-driven potassium excretion, but in this context cyclosporine is the medication most classically linked to hyperkalemia due to its nephrotoxic effects on renal handling of potassium.

The main idea here is how certain drugs disturb kidney potassium handling to raise serum potassium. Cyclosporine, a calcineurin inhibitor often used in transplant patients, is well known for causing hyperkalemia. It narrows the afferent arteriole, which lowers renal blood flow and glomerular filtration rate. With a lower GFR, less potassium is filtered and excreted, and the distal nephron’s ability to secrete potassium can also be impaired. Additionally, there may be a tubular dysfunction and blunted aldosterone response, further reducing potassium disposal.

In contrast, diuretics like furosemide and thiazides promote potassium loss and typically cause hypokalemia, not hyperkalemia. ACE inhibitors can cause hyperkalemia by reducing aldosterone-driven potassium excretion, but in this context cyclosporine is the medication most classically linked to hyperkalemia due to its nephrotoxic effects on renal handling of potassium.