This is attributable to the use of spironolactone in low dose and strict adherence to exclusion criteria. Patients with pre-existing hyperkalemia or significant renal impairment, however, are ineligible for this treatment. When initiating spironolactone therapy, physicians must monitor potassium and creatinine levels closely. The Clinical Update section is edited by Dr. Donald Farquhar, head of the Division of Internal Medicine, Queen's University, Kingston, Ont. The updates are written by members of the division.
Aldosterone escape during angiotensin-converting enzyme inhibitor therapy in chronic heart failure.