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Abstract: PO2329

Racial and Ethnic Predictors of Hyperkalemia Recurrence

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Streja, Elani, VA Long Beach Healthcare System, Long Beach, California, United States
  • Hsiung, Jui-Ting, VA Long Beach Healthcare System, Long Beach, California, United States
  • Agiro, Abiy, AstraZeneca PLC, Cambridge, Cambridgeshire, United Kingdom
  • Brahmbhatt, Yasmin G., AstraZeneca PLC, Cambridge, Cambridgeshire, United Kingdom
  • Cooper, Kerry, AstraZeneca PLC, Cambridge, Cambridgeshire, United Kingdom
  • Kalantar-Zadeh, Kamyar, VA Long Beach Healthcare System, Long Beach, California, United States
Background

Understanding predictors of recurrent HK may help healthcare providers provide a more individualized approach to HK management. This study aims to explore if race and ethnicity are independently associated with recurrent HK.

Methods

The cohort consisted of 2,457,498 US veterans who had a HK event (sK >5.0 mEq/L) between 2004 and 2018. We evaluated possible demographic predictors of 1-year HK recurrence using Fine and Gray competing risk regression model, which the competing event was all-cause mortality within 1 year after index HK event. We defined HK recurrence as the third or later potassium measurement after the index HK measurement, and patients need to have at least one or more normal potassium measurements (≤5 mEq/L) between the HK events.

Results

Cohort mean age was 63±13yrs, mean index potassium level was 5.31±0.29 mEq/L, and median (IQR) index eGFR was 68 (49,86) mL/min/1.73m2; 96% were male, 13% were Blacks, and 6% were Hispanic. Overall, 17% of patients had a HK recurrence within 1 year after index HK occurrence.

Black patients had a 19% higher risk of 1-year HK recurrence (hazard ratio [HR] [95% Cl]: 1.19 [1.18, 1.20]) compared to White patients. Hispanic patients had a 34% higher risk of 1-year HK recurrence (hazard ratio [HR] [95% Cl]: 1.34 [1.32, 1.36]) compared to non-Hispanic patients. Other predictors for high risk of 1-year HK recurrence include older age (15% higher for each 15 year increment of age) and male (22% higher compared to female) (Table).

Conclusion

Being Hispanic, Black, male, or older age, was associated with a higher risk of HK recurrence within 1 year after index HK event. Further studies are needed to understand the reasons for these disparities and their potential associations with clinical management of HK.

Funding

  • Commercial Support – AstraZeneca