Abstract: SA-PO059

Incident Trends in Hyperkalaemia among Patients with AKI in the Irish Health System

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Browne, Leonard, University of Limerick, Limerick, Ireland
  • Aruna udayakumar, Arunkumar, University Of Limerick, Limerick, Ireland
  • Hsiao-Fang-Yen, Natalie, University Hospital Limerick, Limerick, Ireland
  • Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
  • Stack, Austin G., Graduate Entry Medical School, University of Limerick, Limerick, Ireland
Background

Acute Kidney Injury (AKI) is increasingly common and associated with adverse clinical outcomes in the health system. Hyperkalaemia is an equally dangerous electrolyte disorder that frequently develops in the setting of AKI but little is known regarding its occurrence in this setting.

Methods

We utilised data from the National Kidney Disease Surveillance System in Ireland to explore trends in incident hyperkalaemia occurring in the setting of AKI from 2005 to 2014 (n= 47,259). AKI was identified from laboratory system per KDIGO guidelines and serum potassium recorded concurrently were graded as mild> 5.0, moderate 5-5-6.0, and severe > 6.0 mmol/L. Incidence rates per 100 patients were computed and multivariable logistic models explored the relationship of calendar year with incidence of hyperkalaemia expressed as odds ratio (OR) and 95% Confidence Intervals (CI) with adjustment for age, sex, county of residence, location of medical supervision and laboratory variables.

Results

From 2005 to 2014, incident rates of hyperkalaemia increased from 12.6% (11.7, 13.5) to 17.3 % (16.1, 18.4), P<0.001. Rates of mild hyperkalaemia remained relatively overall stable during period [from 8.2% ((7.5, 9.0) to 9.0% (8.1, 9.8) respectively], while rates of moderate and severe hyperkalaemia increased significantly [from 2.5% (2.05, 2.9) to 4.3% (3.7, 4.9) and from 1.9% (1.6, 2.3) to 4.0 % (3.4, 4.6) respectively, P<0.001. With adjustment for age, sex and baseline eGFR,the OR of hyperkalaemia > 5.0 mmol/L increased with calendar year from 2005 (OR, 1.00) to 2014 (OR,1.55, 95% CI 1.38-1.75). With additional adjustment for location of medical supervision, county of residence, laboratory indicators of health, the likelihood decreased

Conclusion

The incidence of hyperkalaemia has increased in the Irish Health system in well-defined demographic and clinical settings. The increasing trend is largely explained by changes in health status and practices in location of supervision.

Funding

  • Government Support - Non-U.S.