Liquorice-induced hypokalaemia in patients treated with Yokukansan preparations: identification of the risk factors in a retrospective cohort study.
Liquorice-induced hypokalaemia in patients treated with Yokukansan preparations: identification of the risk factors in a retrospective cohort study.
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DOI：
10.1136/bmjopen-2016-014218
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发表时间：
2017-06-15
期刊：
影响因子：
2.9
通讯作者：
Homma M
中科院分区：
文献类型：
--
作者：
Shimada S;Arai T;Tamaoka A;Homma M
目的：评价含甘草的日本传统中药甘草散(YK)和YKCH治疗患者的血钾水平和低钾血症发生率。回顾性队列研究。在日本筑波大学医院接受YK痴呆症和其他精神障碍治疗的患者。389例患者(男174例，女174例，年龄68.6±16.1岁)用YK制剂治疗231天(6~2788天)。排除服用YK制剂前血钾水平为<；3.6mEq/L的患者和药物不依从性患者。YK制剂致低钾血症的发生率及危险因素评估。在服用YK制剂的389例患者中，94例(24.2%)在服用YK制剂后34天(1-1600d)出现低钾血症(钾水平和Lt；3.6mEq/L)。36例(38.3%)患者合并低血钾药物(利尿剂、糖皮质激素、盐皮质激素和甘草酸苷)，无低钾血症者(17.3%)多见(P<；0.05)。COX比例风险模型确定了低钾血症的四个危险因素：服用YK(不服用益气康)(HR 3.093，95%CI 1.408至6.798)、联合服用 (HR 2.743，95%CI 1.754至4.289)、基线低蛋白血症(HR 2.145，95%CI 1.360至3.384)和全量服用(7.5LPK g/d)(HR 1.600，95%CI 1.005至2.549)。对于有以下危险因素的患者，应至少每月进行血钾监测：LPID联合给药、YK给药、低蛋白血症和全量给药。
To evaluate serum potassium levels and rates of hypokalaemia in patients treated with liquorice-containing Japanese traditional Kampo-medicines Yokukansan (YK) and Yokukansan-ka-chinpihange (YKCH). Retrospective cohort study. Patients receiving YK preparations for dementia and other psychiatric disorders in the University of Tsukuba Hospital in Japan. 389 patients (male/female: 174/215, 68.6±16.1 years) were treated with YK preparations for 231 days (range 6–2788 days). Patients whose potassium levels were <3.6 mEq/L before administration of YK preparations, and drug non-compliant patients, were excluded. The occurrence rate of hypokalaemia and assessment of the risk factors for YK preparation-induced hypokalaemia. Of the 389 patients treated with YK preparations, 94 (24.2%) developed hypokalaemia (potassium levels <3.6 mEq/L) 34 days (range 1–1600 days) after administration of the preparations. 36 (38.3%) patients had co-administration with lower potassium-inducing drugs (LPIDs; diuretics, glucocorticoids, mineralocorticoids and glycyrrhizin), which was more frequent in the patients without hypokalaemia (17.3%) (p<0.05). A Cox proportional hazard model identified four risk factors for hypokalaemia: YK administration (not YKCH) (HR 3.093, 95% CI 1.408 to 6.798), co-administration of LPIDs (HR 2.743, 95% CI 1.754 to 4.289), hypoalbuminaemia at baseline (HR 2.145, 95% 1.360 to 3.384), and full dosage administration (7.5 g/day) (HR 1.600, 95% CI 1.005 to 2.549). Serum potassium monitoring should be done at least monthly in patients with the following risk factors: LPID co-administration, YK administration, hypoalbuminaemia, and full dosage administration.
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DOI：
10.1017/s146114570800970x
发表时间：
2009-03-01
影响因子：
4.8
作者：
Mizukami, Katsuyoshi;Asada, Takashi;Toba, Kenji
通讯作者：
Toba, Kenji
影响因子：
3.2
作者：
Kamei S;Kaneto H;Irie S;Kinoshita T;Tanabe A;Hirukawa H;Tatsumi F;Shimoda M;Kohara K;Mune T;Kaku K
通讯作者：
Kaku K
影响因子：
1
作者：
Yamada, Shunsuke;Tokumoto, Masanori;Ooboshi, Hiroaki
通讯作者：
Ooboshi, Hiroaki
影响因子：
--
作者：
CONN, JW;ROVNER, DR;COHEN, EL
通讯作者：
COHEN, EL
DOI：
10.1002/tkm2.1058
发表时间：
2016-01-01
期刊：
Traditional & Kampo Medicine
影响因子：
--
作者：
Yoshino, T.;Nakamura, H.;Watanabe, K.
通讯作者：
Watanabe, K.