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J Am Coll Cardiol, 2005; 46:845-849, doi:10.1016/j.jacc.2005.06.010 (Published online 9 August 2005).
© 2005 by the American College of Cardiology Foundation
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The Adequacy of Laboratory Monitoring in Patients Treated With Spironolactone for Congestive Heart Failure

Keyur B. Shah, MD*, Krishnamurti Rao, BS{dagger}, Robert Sawyer, MD{ddagger} and Stephen S. Gottlieb, MD, FACC§,*

* Department of Medicine, The University of Maryland School of Medicine and the Baltimore Veterans Affairs Medical Center, Baltimore, Maryland
{dagger} Division of Cardiology, The University of Maryland School of Medicine and the Baltimore Veterans Affairs Medical Center, Baltimore, Maryland
{ddagger} Department of Otorhinolaryngology-Head and Neck Surgery, The University of Maryland School of Medicine and the Baltimore Veterans Affairs Medical Center, Baltimore, Maryland
§ Division of Cardiology, The University of Maryland School of Medicine and the Baltimore Veterans Affairs Medical Center, Baltimore, Maryland



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  		Figure 1 The laboratory monitoring follow-up of patients with heart failure started with spironolactone. One-third of the patients did not have serum potassium checked within three months of drug initiation.

 


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  		Figure 2 The incidence of hyperkalemia associated with various baseline serum creatinine concentrations. Note that even a modest increase in creatinine concentration increases the risk of hyperkalemia.

 




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