Herzinsuffizienz-Therapie: Was tun, wenn das Kalium erhöht ist?

Chronic hyperkalemia is common in the medical treatment of patients with heart failure. Serum potassium levels over 5,5 mmol/l require confirmation und changes preferably in drugs that block the RAAS (renin angiotensin aldosteron system). The first step is to stop these drugs and to evaluate kidney function. Once postassium levels return to normal range, the medication can be reintroduced stepwise. Lower doses should be used initially with controlled uptitration. Aldosteron Antagonists may be tolerated only in low doses. Intestinal potassium binders may offer a way to tolerate all drugs which improve prognosis.