Abstract: TH-PO1107

Prevalence of Hyperkalemia in Patients with ESRD Undergoing Hemodialysis

Session Information

Category: Fluid, Electrolytes, and Acid-Base

  • 704 Fluid, Electrolyte, Acid-Base Disorders

Authors

  • Balamuthusamy, Saravanan, Texas Research Institute and PPG Healthcare PA, Fort Worth, Texas, United States
  • Reddi, Alagarsamy l, Texas Research Institute and PPG Healthcare PA, Fort Worth, Texas, United States
  • Ponnaih, Sankarapandian, Texas Research Institute and PPG Healthcare PA, Fort Worth, Texas, United States
  • Dhelaria, Ranjit Kumar, Texas Research Institute and PPG Healthcare PA, Fort Worth, Texas, United States
  • Sankarapandian, Balamurugan, Texas Research Institute and PPG Healthcare PA, Fort Worth, Texas, United States
Background

Adverse cardiovascular events are the most common reason for mortality and morbidity in patient with ESRD. Hyperkalemia is a well-known etiology of cardiac arrhythmias in ESRD and non-ESRD patients. We have analyzed the prevalence of hyperkalemia in prevalent hemodialysis patients dialyzed 3 times a week in an outpatient dialysis clinic.

Methods


Retrospective analysis of serum potassium levels in ESRD patients undergoing hemodialysis in 9 dialysis clinics. pre-dialysis Potassium levels were measured as per dialysis protocol. Based on serum potassium levels, patients divided into four groups i) Hypokalemia (Serum K level less than 3.5) ii) normokalemia (Serum K level between 3.6 to 5.4 mmol/lit), iii} moderate hyperkalemia (Serum K level between 5.5 to 5.9 mmol/lit), and iv) severe Hyperkalemia (Serum K level more than 6.0 mmol/lit). Institutional approval was obtained to review charts.

Results

1022 ESRD patients undergoing hemodialysis were included in the analysis. 2.25% of these patients had severe and 6.75% had moderate hyperkalemia; 2.5% had hypokalemia and the remaining 88.5% had normokalemia.

Conclusion

We have estimated that 9% of HD patients either had moderate or severe hyperkalemia and 2.5% had hypokalemia. The risk of adverse cardiac events is greater when there are rapid fluctuations in serum K which is more likely to occur in hyperkalemic patients dialyzed with 2K baths. Ability to auto-titrate dialysis baths based on serum potassium levels might help mitigate the rapid fluctuations in serum potassium in hyperkalemic dialysis patients.