Kidney Week

Abstract: PO1461

Characteristics of CKD Patients with Hyperkalemia: A Report from the DISCOVER CKD Retrospective Cohort

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

• James, Glen, AstraZeneca UK Ltd, Cambridge, Cambridgeshire, United Kingdom

Glen James,

• Carrero, Juan Jesus, Karolinska Institutet, Stockholm, Stockholm, Sweden

Juan Jesus Carrero,

• Kumar, Supriya R., AstraZeneca, Gaithersburg, Maryland, United States

Supriya R. Kumar,

• Fishbane, Steven, Northwell, Manhasset, New York, United States

Steven Fishbane,

• Moreno Quinn, Carol Patricia, AstraZeneca UK Ltd, Cambridge, Cambridgeshire, United Kingdom

Carol Patricia Moreno Quinn,

• Wittbrodt, Eric T., AstraZeneca, Gaithersburg, Maryland, United States

Eric T. Wittbrodt,

• Kanda, Eiichiro, Kawasaki Medical School, Kurashiki, Okayama, Japan

Eiichiro Kanda,

• Hedman, Katarina, AstraZeneca, Gothenburg, Sweden

Katarina Hedman,

• Kashihara, Naoki, Kawasaki Medical School, Kurashiki, Okayama, Japan

Naoki Kashihara,

• Kosiborod, Mikhail, Saint Luke's Mid America Heart Institute, Kansas City, Missouri, United States

Mikhail Kosiborod,

• Carolyn, Lam Su ping, National Heart Centre Singapore, Singapore, Singapore

Lam Su ping Carolyn,

• Pollock, Carol A., University of Sydney, Sydney, New South Wales, Australia

Carol A. Pollock,

• Stenvinkel, Peter, Karolinska Universitetssjukhuset, Stockholm, Sweden

Peter Stenvinkel,

• Wheeler, David C., University College London, London, London, United Kingdom

David C. Wheeler,

• Pecoits-Filho, Roberto, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Roberto Pecoits-Filho,

Background

Hyperkalemia (HK), defined as serum potassium (sK⁺) >5.0 mmol/L, is a potentially fatal condition most often observed in patients with chronic kidney disease (CKD), heart failure (HF) or diabetes and exacerbated by medications that inhibit the renin-angiotensin aldosterone system (RAASi). This real-world study describes characteristics of patients with HK in a large observational international study of CKD patients.

Methods

The DISCOVER CKD retrospective cohort was extracted using the US TriNetX hospital-EMR and Japan Medical Data Vision (JMDV) databases. The study included patients aged >18 years (>20 JMDV) with a diagnostic CKD code (stage 3A to Stage 5 including renal replacement therapy [RRT]) or 2 estimated glomerular filtration rate (eGFR) measures <75 mL/min/1.73m² at least 90 days apart between January 2008 and March 2020. The index date was 2^nd sK⁺ measurement >5.0 mmol/L. Descriptive analyses were used.

Results

Preliminarily, 16436 CKD patients with HK (43% female, mean±SD age 72.2±13.7 years) were identified. Common comorbidities included HF, hypertension and type 2 diabetes, which increased in prevalence with increasing HK severity, Table 1. Mean eGFR was 43.3±24 mL/min/1.73m² and mean sK⁺ was 5.4±0.5 mmol/L. HK severity, RAASi and diuretic use increased as mean eGFR decreased.

Conclusion

HK was more common in patients with significant comorbidities where RAAS inhibitors have evidence-based indications. Future analyses will determine whether HK limits appropriate management of these comorbidities.