MRAs and Low-Ceiling Diuretics Drive Potassium Shifts in Elderly Polypharmacy
This dual-cohort real-world analysis ranks the relative potassium impact of common cardiorenal drug classes across chronic kidney disease stages in older, multi-medicated patients, informing which agents warrant the closest monitoring.
📅 Journal publication: Jun 27, 2026·Last updated: Jul 21, 2026
Potassium imbalances are common in older patients on multiple drugs.
Potassium imbalances in older adults on multiple medications can lead to serious health implications. Hypokalemia occurred in 28.4% and hyperkalemia in 20.3% of patients; MRAs and diuretics notably affected potassium levels depending on CKD stage. Renal function and specific drug classes should be carefully monitored to prevent adverse potassium level changes in older patients. The study highlights risks of polypharmacy in older adults with CKD. Monitoring potassium levels in multi-medicated older adults is crucial, particularly when using MRAs and diuretics.
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Authors:Laurentius T, Al-Musawer E, Schmitz K, Bollheimer C, Wozniak J, Graeff V, Kriegisch-Stumpf A, Knüppel-Ruppert A, Dormann H, Stingl JC, Just KS
Citation:Laurentius T, Al-Musawer E, Schmitz K, et al. Influence of drugs on blood potassium levels in older, multi-medicated patients - results of two cohort studies focusing on adverse drug reactions. BMC geriatrics. 2026;26(1). doi:10.1186/s12877-026-07899-5