Elevated baseline potassium level within reference range is associated with worse clinical outcomes in hospitalised patients

Abstract

The clinical significance of elevated baseline serum potassium (K+) levels in hospitalised patients is rarely described. Hence, we performed a retrospective study assessing the significance of elevated K+ levels in a one-year admission cohort. Adult patients without hypokalaemia or end-stage renal disease were included. Adverse outcomes were all-cause mortality, hospital-acquired acute kidney injury, and events of arrhythmia. In total, 17,777 patients were included in the study cohort, and a significant difference (P < 0.001) was observed in mortality according to baseline serum K+ levels. The adjusted hazard ratios (HRs) and associated 95% confidence intervals (CIs) of all-cause mortality for K+ levels above the reference range of 3.6–4.0 mmol/L were as follows: 4.1–4.5 mmol/L, adjusted HR 1.075 (95% CI 0.981–1.180); 4.6–5.0 mmol/L, adjusted HR 1.261 (1.105–1.439); 5.1–5.5 mmol/L, adjusted HR 1.310 (1.009–1.700); >5.5 mmol/L, adjusted HR 2.119 (1.532–2.930). Moreover, the risks of in-hospital acute kidney injury and arrhythmia were higher in patients with serum K+ levels above 4.0 mmol/L and 5.5 mmol/L, respectively. In conclusion, increased serum K+ levels, including mild elevations may be related to worse prognosis. Close monitoring and prompt correction of underlying causes or hyperkalaemia itself is warranted for admitted patients.

Hyperkalaemia in people with diabetes: occurrence, risk factors and outcomes in a Danish population‐based cohort study

“…In line with our findings, studies have documented an increasing risk of hyperkalaemia in patients with progressively worsening kidney function and in patients with heart failure , as well as among those receiving renin angiotensin aldosterone system inhibitors and in those with advanced age . Although it is well‐known that hyperkalaemia is associated with increased ventricular arrhythmias and may be associated with other adverse outcomes , to the best of our knowledge, there have been no previous studies of these associations specifically in people with diabetes.…”

High-sensitivity ion detection at low voltages with current-driven organic electrochemical transistors

“…For example, they preserve suitable pressure and balance of various body fluids inside and between cells, as well as blood. Moreover, they are essential for maintaining suitable acidity into the body, passively balancing out the ions of tissue, blood, and organs 1 , 2 , 4 , 36 , 37 . A tungsten foil or Ag/AgCl pellet is immersed into the electrolyte and used as gate electrode.…”

Behavioural patterns of electrolyte repletion in intensive care units: lessons from a large electronic dataset

“…Maintaining “normal” levels of potassium and magnesium is believed to prevent cardiac arrhythmias and is often prioritized for patients on diuretics to avoid hypokalemia 10 , 16 . Conversely, patients on potassium sparing diuretic and with chronic kidney disease are perceived to be at higher risk of hyperkalaemia 11 , 14 , 16 . As electrocardiogram analyses were unfortunately not available, we addressed this question by studying whether there was a change in maximum heart rate after repletion, as a surrogate for tachyarrhythmias.…”

“…Maintaining “normal” serum levels of these electrolytes is perceived to be important despite (albeit somewhat limited) evidence that aggressive electrolyte replacement does not dramatically decrease the incidence of adverse events 9 , 12 , 13 . Furthermore, a chronically high-normal serum potassium level may be related to increased mortality 14 . Calcium and phosphate are also critical for muscle contractility 7 , 15 , 16 .…”