Low Rates of Monitoring Renal Function and Electrolytes in Heart Failure Patients Taking MRAs

Patients with heart failure often are prescribed mineralocorticoid-receptor antagonists (MRAs; e.g., spironolactone, eplerenone). Clinical practice guidelines recommend that patients who take MRAs be monitored closely for renal function and electrolyte levels. To assess adherence to these guidelines, researchers examined Medicare claims data on newly prescribed MRAs in 10,443 heart failure patients (mean age, 79). Nearly half of patients had chronic kidney disease (CKD); more than half were receiving angiotensin-converting–enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs). Appropriate monitoring was defined as measurement of serum creatinine and potassium levels within 120 days before MRA initiation, ≥2 such measurements withi…