Elderly heart failure patients with drug-induced serious hyperkalemia

We report four cases of hyperkalemia induced by the association of spironol actone with ACE inhibitor in geriatric patients. Over a period of one year, four elderly patients treated for congestive heart failure with this assoc iation were admitted to the Geriatric Ward with serious hyperkalemia. These occurrences represented one third of all-cause severe hyperkalemia cases a dmitted during this one-year period. A common observation in our cases was that the dose of spironolactone employed far exceeded the recommended dosag es. These cases illustrate that spironolactone dosage must be kept low in t he setting of chronic congestive heart failure treatment, as well as the ne ed for close monitoring of frail elderly patients who are given this combin ation. (Aging Clin. Exp. Res. 12: 315-319, 2000) (C) 2000, Editrice Kurtis.