Kidney Week

Abstract: PO1460

Association Between Dyskalemias and Short-Term Hospital/Emergency Department Visits in Patients with Advanced CKD Transitioning to Dialysis

Session Information

• Fluid, Electrolyte, and Acid-Base Disorders: Clinical - 1
  October 22, 2020 | Location: On-Demand
  Abstract Time: 10:00 AM - 12:00 PM

Category: Fluid, Electrolyte, and Acid-Base Disorders

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

Authors

• Dashputre, Ankur A., The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Ankur A. Dashputre,

• Sumida, Keiichi, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Keiichi Sumida,

• Gatwood, Justin, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Justin Gatwood,

• Thomas, Fridtjof, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Fridtjof Thomas,

• Akbilgic, Oguz, Loyola University Chicago, Chicago, Illinois, United States

Oguz Akbilgic,

• Potukuchi, Praveen Kumar, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Praveen Kumar Potukuchi,

• Obi, Yoshitsugu, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Yoshitsugu Obi,

• Molnar, Miklos Zsolt, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Miklos Zsolt Molnar,

• Streja, Elani, University of California Irvine, Irvine, California, United States

Elani Streja,

• Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States

Kamyar Kalantar-Zadeh,

• Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

Background

Patients with advanced CKD may experience immediate hospital/emergency department (ED) visit due to dyskalemia-associated adverse events (e.g. arrhythmias). The association of dyskalemias with short-term hospital/ED visits is understudied amongst those with advanced CKD transitioning to dialysis.

Methods

From among 102,477 US Veterans transitioning to dialysis between 2007-2015, we identified 21,150 patients with pre-dialysis eGFR <30 ml/min/1.73m² and a concurrent plasma potassium (K) measurement. We examined the association of hypokalemia [K <3.5], hyperkalemia [K >5.5] and normokalemia [3.5-5.5, reference] with hospital/ED visits within 2 days of plasma K measurement using logistic regressions adjusted for sociodemographics, smoking status, comorbidities, BMI, healthcare encounters, SBP, medications and eGFR.

Results

The mean age of the cohort was 67.3 years; 98% were male; 32% were African American. The mean eGFR and K were 22.3 ml/min/1.73m² and 4.6 mEq/L, respectively, and 7% and 3.5% of patients were hyper- and hypokalemic, respectively. Three % of patients experienced a hospital/ED visit. Both hyper- and hypokalemia were significantly associated with higher risk of a hospital/ED visit in the crude (ORs [95% CIs] 2.73 [2.22-3.37] and 2.28 [1.68-3.09], respectively) and multivariable-adjusted models (2.47 [1.98-3.09] and 1.88 [1.37-2.58], respectively) (Figure).

Conclusion

Hyper- and hypokalemia are associated with higher short-term risk of hospital/ED visits in patients with advanced CKD. Preventing dyskalemias may help in reducing the incidence of short-term hospital/ED visit.

Association between dyskalemias and short-term hospital/emergency department visits in patients with advanced CKD

Funding

• NIDDK Support