Retrospective Study of the Prevalence of Hyperkalemia in Women Taking Spironolactone for Acne, Hair Loss, and Hirsutism

This retrospective study examined the prevalence of hyperkalemia in 974 women taking spironolactone for acne, hair loss, and hirsutism, excluding those with conditions or medications affecting potassium levels. Hyperkalemia was defined as potassium levels ≥ 5.1 mmol/L. Out of 1273 courses of spironolactone, 447 courses (35.1%) showed an increase in potassium levels, with 171 courses (13.4%) showing an increase of ≥ 10%, and 25 courses (2.0%) having end values above the upper limit of normal. Age, race, ethnicity, course duration, and cumulative dose were not significant predictors of hyperkalemia. The study concluded that while the overall rate of hyperkalemia was low, monitoring potassium trends during spironolactone treatment is advisable, especially for patients with a history of elevated potassium levels.