Life-Threatening Hyperkalemia: A Complication of Spironolactone for Heart Failure in a Patient with Renal Insufficiency

Abstract
Serum potassium concentration should be measured immediately before operation to detect hyperkalemia in heart failure patients treated with spironolactone. Renal insufficiency, advanced age, potassium supplementation, decompensated congestive heart failure, and a spironolactone dose larger than 25 mg/d increase the risk of hyperkalemia as a consequence of spironolactone therapy.