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Abstract: FR-PO648

Hyperkalemia Progression Rates Among Patients with Mild Hyperkalemia

Session Information

Category: Fluid and Electrolytes

  • 902 Fluid and Electrolytes: Clinical


  • Israni, Rubeen K., AstraZeneca, Newark, Delaware, United States
  • Davis, Jill, AstraZeneca, Newark, Delaware, United States
  • Betts, Keith, Analysis Group, Inc. , Boston, Massachusetts, United States
  • Mu, Fan, Analysis Group, Inc. , Boston, Massachusetts, United States
  • Wang, Jessie, Analysis Group, Inc. , Boston, Massachusetts, United States
  • Anzalone, Deborah A., AstraZeneca, Newark, Delaware, United States
  • Bousleiman, Stephanie, Analysis Group, Inc. , Boston, Massachusetts, United States
  • Koenigsberg, Sarah, Analysis Group, Inc. , Boston, Massachusetts, United States
  • Fonseca, Vivian A., Tulane University Medical Center, New Orleans, Louisiana, United States
  • Uwaifo, Gabriel I., Ochsner Medical Foundation, Slidell, Louisiana, United States
  • Szerlip, Harold M., Baylor University Medical Center, Dallas, Texas, United States

To describe time to progression from mild hyperkalemia (HK) to moderate-to-severe or severe HK among patients with mild HK and pre-specified subgroups.


Adults with at least one mild HK event (i.e. serum potassium [K+] > 5.0 and ≤ 5.5 mEq/L) were identified using electronic medical records from the Research Action for Health Network (2012-2018). Index date was defined as the date of the first mild HK event. Patients were required to have at least one additional serum K+ lab value during the study period (2 years post-index date). Progression to moderate-to-severe and to severe HK was defined as the first occurrences of a serum K+ lab > 5.5 mEq/L and > 6.0 mEq/L, respectively. Kaplan-Meier analyses were conducted to estimate the rates of HK progression over the study period for the overall population and patient subgroups including those with and without chronic kidney disease (CKD in stages 3-5), heart failure (HF), hypertension, or type 2 diabetes (T2D).


A total of 35,369 patients with mild HK were included in the analysis. Mean age was 65.6 years, and 47.5% were women. At 2 years post-index, 16.9% and 8.7% of patients progressed to moderate to severe HK and to severe HK, respectively (Table). Patients with CKD, HF, hypertension, and T2D experienced higher rates of HK progression compared with patients without those conditions (all log-rank p < 0.001) (Table). HK progression rates also increased significantly as CKD stage increased (p < 0.001) (Table).


A total of 16.9% of patients with mild HK experienced HK progression during the 2-year follow-up period. HK progression rates increased significantly with CKD stage and were also higher among those with HF, hypertension, or T2D.


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