Send to

Choose Destination
Nephron Clin Pract. 2007;105(2):c77-83. Epub 2006 Dec 1.

Incidence and predictors of development of acute renal failure related to treatment of congestive heart failure with ACE inhibitors.

Author information

Bahian School of Medicine and Public Health, Salvador-Bahia, Brazil.



Recent studies have shown high rates of morbimortality associated with hyperkalemia in congestive heart failure (CHF) patients treated with angiotensin-converting enzyme inhibitors (ACEI) plus spironolactone and the best predictor of this electrolytic disorder was a decrease in renal function. We aim to identify the incidence and predictors of acute renal failure (ARF) related to treatment with ACEI associated or not with spironolactone.


We conducted a cohort study and followed 114 consecutive cases of CHF patients treated with ACEI at admission to a University Hospital. We performed measurements of serum creatinine and potassium levels three times a week, and systolic and diastolic blood pressures every 8 h, daily.


Among 114 patients, 25% developed ARF, 15% hyperkalemia and 3% severe hyperkalemia. Predictors of ARF were a decrease in average blood pressure 25 mm Hg (OR 18.2; 95% CI: 6.2, 53.5); class IV CHF (OR 4.7; 95% CI: 1.7, 12.7), diabetes (OR 2.6; 95% CI: 1.1, 6.4) and hypertension (OR 3.0; 95% CI: 1.2, 7.4).


ARF and hyperkalemia are common complications in CHF patients after treatment with ACEI. Diabetic, hypertensive and class IV CHF patients who experienced a decrease in average blood pressure 25 mm Hg were more susceptible to ARF.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for S. Karger AG, Basel, Switzerland
Loading ...
Support Center