Treatment-induced increase in total body potassium in patients at high risk of ventricular arrhythmias: a randomized POTCAST substudy
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Objective Hypokalemia is associated with increased risk of arrhythmias and it is recommended to monitor plasma potassium (p-K) regularly in at-risk patients with cardiovascular diseases. It is poorly understood if administration of potassium supplements and mineralocorticoid receptor antagonists (MRA) aimed at increasing p-K also increases intracellular potassium. Methods Adults aged≥18 years with an implantable cardioverter defibrillator (ICD) were randomized (1:1) to a control group or to an intervention that included guidance on potassium rich diets, potassium supplements, and MRA to increase p-K to target levels of 4.5-5.0 mmol/l for six months. Total-body-potassium (TBK) was measured by a Whole-Body-Counter along with p-K at baseline, after six weeks, and after six months. Results Fourteen patients (mean age: 59 years (standard deviation 14), 79% men) were included. Mean p-K was 3.8 mmol/l (0.2), and mean TBK was 1.50 g/kg (0.20) at baseline. After six-weeks, p-K had increased by 0.47 mmol/l (95%CI:0.14;0.81), p = 0.008 in the intervention group compared to controls, whereas no significant difference was found in TBK (44 mg/kg (-20;108), p = 0.17). After six-months, no significant difference was found in p-K as compared to baseline (0.16 mmol/l (-0.18;0.51), p = 0.36), but a significant increase in TBK of 82 mg/kg (16;148), p = 0.017 was found in the intervention group compared to controls. Conclusions Increased potassium intake and MRAs increased TBK gradually and a significant increase was seen after six months. The differentially regulated p-K and TBK challenges current knowledge on potassium homeostasis and the time required before the full potential of p-K increasing treatment can be anticipated.
Originalsprog | Engelsk |
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Artikelnummer | e0288756 |
Tidsskrift | PLOS ONE |
Vol/bind | 18 |
Udgave nummer | 7 |
Antal sider | 12 |
ISSN | 1932-6203 |
DOI | |
Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
This study was supported by: The Danish Council for Independent Research Grant recipient: CJ Grant Number: 8020-00399B Url: https://dff.dk/en The Hartmann Foundation Grant recipient: HB Grant Number: 2019 Url: https://www. hartmannfonden.dk/english/The Danish Heart Foundation Grant recipient: HB Grant Number: 2019 Url: https://hjerteforeningen.dk/Snedkermester Sophus Jacobsen og hustru Astrid Jacobsens Fond Grant recipient: HB Grant Number: 2019 Url: https://sophusjacobsenfond.dk/The Novo Nordisk Foundation Grant recipient: NR Grant Number: NNF20OC0064048 Url: https://novonordiskfonden.dk/The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
Copyright: © 2023 Winsløw et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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