ArticleBMC primary care2026
Incidence of hyperkalaemia and major creatinine elevation after renin-angiotensin system inhibitor initiation in a Singapore primary care cohort.
Article in BMC primary care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Trajectory models of serum creatinine and 28-day mortality in critically ill patients with sepsis complicated by type 2 diabetes mellitus: a cohort study.Frontiers in endocrinology · 2026Article
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4 authors.
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Abstract
backgroundRenin-angiotensin system inhibitors (RASis), including ACE inhibitors (ACEis) and angiotensin receptor blockers (ARBs), are commonly initiated in primary care for various clinical indications. However, the risk of hyperkalaemia and increased serum creatinine levels after initiation has not been well studied in Asian populations.
methodsWe conducted a retrospective cohort study of all patients aged 18 years and older who initiated RASi treatment at National University Polyclinics, a network of seven primary care clinics in Singapore, between 28 September 2020 and 31 June 2024. The study outcomes were the incidence of hyperkalaemia and elevated serum creatinine levels after RASi initiation. Multivariable regression was used to evaluate the covariates associated with these outcomes.
resultsThe cohort comprised 9,926 patients whose baseline creatinine and post-initiation creatinine or potassium data were available. Within our cohort, 181 patients (1.8%) had hyperkalaemia, comprising 149 (1.5%) mild cases, 28 (0.3%) moderate cases and 4 (< 0.1%) severe cases; 249 (2.5%) patients had a major elevation in serum creatinine of 30% or more from baseline. Risk factors for hyperkalaemia include age, Indian or 'Other' ethnicity, increased baseline serum creatinine and increased baseline serum potassium. For major serum creatinine elevation, risk factors included 'Other' ethnicity, comorbid diabetes mellitus and concomitant diuretic use.
conclusionHyperkalaemia and major serum creatinine elevation are uncommon adverse events following RASi initiation.
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