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Abstract: SA-PO790

Proactive Identification and Nutritional Management of Hyperkalemia via Electronic Health Record Phenotyping

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Son, Jung Hoon, pulseData, New York, New York, United States
  • Wiener, Lauren Alexandra, pulseData, New York, New York, United States
  • Fielding, Ollie, pulseData, New York, New York, United States
  • Yu, Tia Yue, pulseData, New York, New York, United States
  • Liu, Frank, The Rogosin Institute, New York, New York, United States
  • Silberzweig, Jeffrey I., The Rogosin Institute, New York, New York, United States

Group or Team Name

  • PEAK Team at The Rogosin Institute
Background

Hyperkalemia is common chronic kidney disease (CKD) patients and is often associated with adverse cardiac events. Patients with CKD are at increased risk of hyperkalemia due to impaired potassium homeostasis. CKD patients on long-term RAAS inhibitors and/or potassium-sparing diuretics are at increased risk of hyperkalemia, as are those with history of hyperkalemia who are not treated with potassium-binding agents. Targeted nutritional guidance is a low-cost, low-risk intervention for reducing hyperkalemic events.

Methods

Using longitudinal data of 110,998 patients from the Rogosin Institute, a rule-based cohorting criteria (Fig 1) was created using a custom web-based interface provided by pulseData to identify patients who are hyperkalemic or are at risk of hyperkalemia. A two-step workflow was developed: 1) EHR data-driven identification of patients at risk for hyperkalemia and 2) targeted delivery of a nutritional flyer to high-risk patients.

Results

1) Data-driven identification: We developed a method to systematically identify high-risk patients and facilitate targeted delivery of the nutritional intervention. On retrospective review, this query identifies on average 10 patients each week.

2) Nutritional Guidance: A nutritional flyer was created to inform the identified patients on which high-potassium foods which should be avoided. Using a flyer is a less costly resource than an appointment with a nutritionist and can be brought with the patient to the grocery store.

Conclusion

A proactive, data-driven method was developed for delivery of nutritional guidance to high-risk patients to reduce future hyperkalemic events. This workflow will be implemented at The Rogosin Institute. Data will be collected on subsequent hyperkalemia events.

Figure 1