Evidence map›Paper›PMID 33971831›Full record

ArticleBMC nephrology2021

Severe secondary hyperkalemia and arrhythmia from drug interactions between calcium-channel blocker and voriconazole: a case presentation.

Xinju Zhao, Chunyan Zhang, Li Zhu, Bei Wu, Yun Han, Michael Heung, Li Zuo

Open access · goldAbstract readCase Reports
In one paragraph

Article in BMC nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 47% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Xinju ZhaoDepartment of Nephrology, Peking University People's Hospital, Beijing, China. zxjrmyy@163.com.ORCID 0000-0001-8904-201X
Chunyan ZhangDepartment of pharmacy, Peking University People's Hospital, Beijing, China.
Li ZhuDepartment of Nephrology, Peking University People's Hospital, Beijing, China.
Bei WuDepartment of Nephrology, Peking University People's Hospital, Beijing, China.
Yun HanDivision of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, MI, USA.
Michael HeungDivision of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, MI, USA.
Li ZuoDepartment of Nephrology, Peking University People's Hospital, Beijing, China.
Peking University · CNUniversity of Michigan · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with kidney disease may have concurrent hypertension and infection. Dihydropyridine calcium-channel blockers (CCB) are the most popular class of antihypertensive drugs used in clinical settings and can be metabolized by cytochrome P450 isoenzyme 3A4 (CYP3A4). Voriconazole is a commonly used antifungal treatment and a CYP3A4-inhibitor. Insufficient attention to drug interactions from the concomitant use of CCB and voriconazole may result in serious adverse reactions. CASE PRESENTATION: Here, we report a patient with acute kidney injury on stable anti-neutrophil cytoplasm antibody associated vasculitis who developed hyperkalemia resulting in sinus arrest with junctional escape rhythm attributed to drug interactions of CCB with voriconazole. This is a very rarely reported case and may be an under-recognized complication. After continuous renal replacement therapy and changing the anti-hypertensive drugs, symptoms, and laboratory abnormalities of the patient fully recovered.

conclusionsThis case warns us of severe consequences of drug interactions. Co-prescription of CYP3A4-inhibitors with calcium-channel blockers increases the risk of hypotension and acute kidney injury, which may further induce hyperkalemia and arrhythmia.

Indexed as

Acute Kidney InjuryAgedAntibodies, Antineutrophil CytoplasmicAntifungal AgentsAntihypertensive AgentsCalcium Channel BlockersCytochrome P-450 CYP3A InhibitorsDiagnosis, DifferentialDrug InteractionsFemaleHumansHyperkalemiaRenal Replacement TherapySinus Arrest, CardiacVasculitisVoriconazoleAntibodies, Antineutrophil CytoplasmicAntifungal AgentsAntihypertensive AgentsCalcium Channel BlockersCytochrome P-450 CYP3A InhibitorsVoriconazoleAcute kidney injuryArrhythmiaCalcium‐channel blockersDrug interactionHyperkalemia

Identifiers

PMID33971831
PMCPMC8108408
OpenAlexW3163210532

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.