Hyperkalemia among hospitalized patients and association between duration of hyperkalemia and outcomes

Abstract

IntroductionThe aim of the study was to investigate predictors of mortality in patients hospitalized with hyperkalemia.Material and methodsData among hospitalized patients with hyperkalemia (serum potassium ≥ 5.1 mEq/l) were collected. Patients with end-stage renal disease on dialysis were excluded.ResultsOf 15,608 hospitalizations, 451 (2.9%) episodes of hyperkalemia occurred in 408 patients. In patients with hyperkalemia, chronic kidney disease, hypertension, diabetes, coronary artery disease and heart failure were common comorbidities. Acute kidney injury (AKI) and metabolic acidosis were common metabolic abnormalities, and 359 patients (88%) were on at least one drug associated with hyperkalemia. Mean duration to resolution of hyperkalemia was 12 ±9.9 h. Nonsteroidal anti-inflammatory drugs (HR = 1.59), highest potassium level (HR = 0.61), tissue necrosis (HR = 0.61), metabolic acidosis (HR = 0.77), and AKI (HR = 0.77) were significant independent determinants of duration prior to hyperkalemia resolution. Tissue necrosis (OR = 4.55), potassium supplementation (OR = 5.46), metabolic acidosis (OR = 4.84), use of calcium gluconate for treatment of hyperkalemia (OR = 4.62), AKI (OR = 3.89), and prolonged duration of hyperkalemia (OR = 1.06) were significant independent predictors of in-hospital mortality.ConclusionsTissue necrosis, potassium supplementation, metabolic acidosis, calcium gluconate for treatment of hyperkalemia, AKI and prolonged duration of hyperkalemia are independent predictors of in-hospital mortality.

Preventing Hypoglycemia Following Treatment of Hyperkalemia in Hospitalized Patients

“…H yperkalemia is common in hospitalized patients, with an estimated prevalence of 1%-10%. 1,2 Hyperkalemia can lead to life-threatening cardiac arrhythmias. The risk of arrhythmias increases with serum potassium values >6.5 mmol/L, and hyperkalemia is associated with increased in-hospital mortality.…”

Unsupervised Machine learning to subtype Sepsis-Associated Acute Kidney Injury

“…Throughout the data processing steps, laboratory features derived from albumin, bicarbonate, and potassium were kept as we clinically adjudicated them to be meaningful. (13, 14) Selected features contributed to the final unsupervised clustering.…”

Pharmacodynamics and pharmacokinetics of sodium zirconium cyclosilicate [ZS-9] in the treatment of hyperkalemia

“…[1] Hyperkalemia is a common electrolyte disorder in patients with heart failure (HF), CKD, and diabetes mellitus. [3,4] There is an unmet medical need for effective and safe therapies that can be used both in the acute setting and for chronic maintenance, especially with a growing elderly population whose age-related comorbidities are associated with hyperkalemia and increasing RAASi use in clinical practice. [5] 1.…”