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

Jagadish Khanagavi, Tanush Gupta, Wilbert S. Aronow, Tushar Shah, Jalaj Garg, Chul Ahn, Sachin Sule, Stephen Peterson

Research output: Contribution to journalArticle

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Abstract

Introduction: The aim of the study was to investigate predictors of mortality in patients hospitalized with hyperkalemia. Material and methods: Data among hospitalized patients with hyperkalemia (serum potassium ≥ 5.1 mEq/l) were collected. Patients with end-stage renal disease on dialysis were excluded. Results: Of 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. Conclusions: Tissue necrosis, potassium supplementation, metabolic acidosis, calcium gluconate for treatment of hyperkalemia, AKI and prolonged duration of hyperkalemia are independent predictors of in-hospital mortality.

Original languageEnglish (US)
Pages (from-to)251-257
Number of pages7
JournalArchives of Medical Science
Volume10
Issue number2
DOIs
StatePublished - 2014

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Hyperkalemia
Acidosis
Acute Kidney Injury
Potassium
Calcium Gluconate
Necrosis
Hospital Mortality
Chronic Renal Insufficiency
Pharmaceutical Preparations
Chronic Kidney Failure
Comorbidity
Coronary Artery Disease
Dialysis
Hospitalization
Anti-Inflammatory Agents
Heart Failure
Hypertension

Keywords

  • Drug-induced hyperkalemia
  • In-hospital mortality
  • Potassium supplements
  • Prolonged hyperkalemia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hyperkalemia among hospitalized patients and association between duration of hyperkalemia and outcomes. / Khanagavi, Jagadish; Gupta, Tanush; Aronow, Wilbert S.; Shah, Tushar; Garg, Jalaj; Ahn, Chul; Sule, Sachin; Peterson, Stephen.

In: Archives of Medical Science, Vol. 10, No. 2, 2014, p. 251-257.

Research output: Contribution to journalArticle

Khanagavi, Jagadish ; Gupta, Tanush ; Aronow, Wilbert S. ; Shah, Tushar ; Garg, Jalaj ; Ahn, Chul ; Sule, Sachin ; Peterson, Stephen. / Hyperkalemia among hospitalized patients and association between duration of hyperkalemia and outcomes. In: Archives of Medical Science. 2014 ; Vol. 10, No. 2. pp. 251-257.
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AU - Sule, Sachin

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AB - Introduction: The aim of the study was to investigate predictors of mortality in patients hospitalized with hyperkalemia. Material and methods: Data among hospitalized patients with hyperkalemia (serum potassium ≥ 5.1 mEq/l) were collected. Patients with end-stage renal disease on dialysis were excluded. Results: Of 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. Conclusions: Tissue necrosis, potassium supplementation, metabolic acidosis, calcium gluconate for treatment of hyperkalemia, AKI and prolonged duration of hyperkalemia are independent predictors of in-hospital mortality.

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