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Heart failure hyperkalaemia — RACGP Fellowship MCQ

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HardChronic disease managementHeart failure hyperkalaemiaRACGP Fellowship

A 69-year-old with heart failure and CKD develops dizziness, potassium 5.7 mmol/L and a substantial eGFR fall 2 weeks after spironolactone was added. What is the most appropriate action?

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Correct answer: E — Withhold spironolactone and repeat blood tests

A clinically important potassium rise and kidney-function decline after spironolactone requires prompt medicine review, withholding the likely contributor where appropriate and urgent repeat testing. Assess volume status and other contributors at the same time.

Reference: Kidney Health Australia: CKD Management in Primary Care: https://kidney.org.au/health-professionals/ckd-management-handbook/