ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2020 and some content may be unavailable. To unlock all content for 2020, please visit the archives.

Abstract: PO1445

Post-Discharge Outcomes Among Hyperkalemic Patients Treated with and Without Sodium Polystyrene Sulfonate in the Inpatient Setting

Session Information

Category: Fluid, Electrolyte, and Acid-Base Disorders

  • 902 Fluid, Electrolyte, and Acid-Base Disorders: Clinical


  • Davis, Jill, AstraZeneca, Wilmington, Delaware, United States
  • Israni, Rubeen K., AstraZeneca, Wilmington, Delaware, United States
  • Cook, Erin, Analysis Group, Boston, Massachusetts, United States
  • Mu, Fan, Analysis Group, Boston, Massachusetts, United States
  • Betts, Keith, Analysis Group, Boston, Massachusetts, United States
  • Anzalone, Deborah A., AstraZeneca, Wilmington, Delaware, United States
  • Billmyer, Emma, Analysis Group, Boston, Massachusetts, United States
  • Lemus Wirtz, Esteban J., Analysis Group, Boston, Massachusetts, United States
  • Yin, Lei, Analysis Group, Boston, Massachusetts, United States
  • Szerlip, Harold M., Baylor University Medical Center, Dallas, Texas, United States
  • Uwaifo, Gabriel I., Oschner Medical Center, New Orleans, Louisiana, United States
  • Fonseca, Vivian A., Tulane University Medical Center; Tulane University School of Medicine, New Orleans, Louisiana, United States

Sodium polystyrene sulfonate (SPS) is a common treatment option for hyperkalemia (HK) in the inpatient (IP) setting. However, the post-discharge outcomes of patients with HK treated with and without SPS in the IP setting are not well characterized.


Adult patients with ≥1 IP stay with HK (≥1 potassium [K] lab >5.0 mEq/L) were identified using electronic medical record data from the Research Action for Health Network (2012-2018). Patients treated with SPS during the IP stay were matched 1:1 to patients not treated with SPS on discharge status (dead/alive) and HK severity (most severe K lab during IP stay). Patient characteristics, K levels, HK treatments, length of stay (LOS) and death during IP stay were described. All-cause and HK-related IP readmission, and HK recurrence (in any setting) within 30, 60 and 90 days post-discharge were described and compared using conditional logistic regressions.


A total of 4,847 SPS users were matched to non-SPS users (23.2% K>5.0-5.5, 36.8% >5.5-6.0, 40.0% >6.0 mEq/L). During the stay, 11.7% of patients died in both cohorts. Mean age was 65.7 and 62.1 years for the SPS and non-SPS users. SPS users had a higher burden of comorbidities than non-SPS users, including CKD (79.1% v 57.2%) and heart failure (49.8% v 37.7%; both p<0.001). The average LOS was similar for SPS and non-SPS users (9.0 v 9.1 days) and most patients had their last K level normalized (≤5.0 mEq/L) during the stay (83.0% v 86.2%, p<0.001). Use of temporizing agents was common for SPS and non-SPS users (58.2% v 43.5%, p<0.001); however, very few SPS users received SPS at discharge (0.4%). The 30-day all-cause and HK-related IP readmission rates were 27.0% and 13.6% for SPS users and 19.3% and 5.4% for non-SPS users, respectively. HK recurred within 30 days in 23.0% of SPS users and 7.1% of non-SPS users. The differences remained after adjusting for baseline and IP stay characteristics (odds ratio [95% CI]: all-cause readmission=1.4 [1.2, 1.6]; HK readmission=2.4 [2.0, 2.9]; HK recurrence=3.1 [2.7, 3.6]). The adjusted results were similar for 60 and 90 days post-discharge.


Despite treatment with SPS in the IP setting there was a high burden of readmission and HK recurrence among patients with HK.


  • Commercial Support –