Abstract: FR-PO553
Real-World Evaluation of Empagliflozin on Serum Potassium Levels at a Veterans Affairs Medical Center
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid‚ Electrolyte‚ and Acid-Base Disorders
- 1002 Fluid‚ Electrolyte‚ and Acid-Base Disorders: Clinical
Authors
- Lloyd, Mackenzie, VA Northeast Ohio Healthcare System, Cleveland, Ohio, United States
- Cooney, Danielle N., VA Northeast Ohio Healthcare System, Cleveland, Ohio, United States
- Lyman, Alessandra, VA Northeast Ohio Healthcare System, Cleveland, Ohio, United States
- Singh, Shivali D., VA Northeast Ohio Healthcare System, Cleveland, Ohio, United States
- Burant, Christopher J., VA Northeast Ohio Healthcare System, Cleveland, Ohio, United States
- Desai, Niraj, VA Northeast Ohio Healthcare System, Cleveland, Ohio, United States
Background
Recent major clinical trial results show conflicting data regarding the impact of sodium glucose co-transporter 2 (SGLT2i) inhibitors on serum potassium (K+) levels. This study aimed to identify the effect of SGLT2i use on serum K+ levels in a real-world setting.
Methods
We performed a retrospective cohort study of patients prescribed empagliflozin at a Veterans Affairs hospital between 12/1/16 and 11/30/21. The primary outcome was change in serum K+ value from the date of first empagliflozin prescription to the following timepoints: 2-4 weeks, 3 months, and 6 months. Secondary outcomes included changes in serum K+ when stratified by eGFR, effect of SGLT2i dose on serum K+ level, and changes to concomitant medications because of dyskalemia (K+ < 3.4 meq/L or K > 5.1 meq/L).
Results
100 patients with baseline potassium levels and 47, 61, and 72 patients were included in the analysis at 2-4 weeks, 3 months, and 6 months, respectively. All patients had type 2 diabetes mellitus, 86% were white, 26% had baseline eGFR of 60 ml/min or lower, and 64% of patients prescribed a renin-angiotensin-aldosterone system inhibitor at baseline. Mean change in serum K+ level from baseline was insignificant at all timepoints: -0.51 mmol/L (95% CI -0.48 to 0.15) at 2-4 weeks, -0.03 mmol/L (95% CI -0.13 to 0.07) at 3 months, and 0.03 mmol/L (95% CI -0.06 to 0.12) at 6 months. Twelve participants had either hypo- or hyperkalemia at any pre-specified timepoint. Hyperkalemia was more common in patients with eGFR < 60 ml/min (70%). There was no dose dependent relationship between SGLT2i and change in serum K+ value. Hypokalemia more often prompted changes to concomitant medications that may impact serum K+ values.
Conclusion
There was no statistically significant change in serum K+ values after empagliflozin initiation in subjects with DM2. Monitoring of serum K after initiation of empagliflozin may be considered in patients with CKD or in patients at risk of hypokalemia.
Funding
- Veterans Affairs Support