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Abstract: TH-PO365

Prevalence, Recurrence, and Prognosis of Hyperkalemia in Real-World Patients in China

Session Information

Category: Fluid, Electrolytes, and Acid-Base Disorders

  • 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical

Authors

  • Jin, Haijiao, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
  • Fan, Yang, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
  • Lu, Renhua, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
  • Wang, Qin, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
  • Zhang, Minfang, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
  • Che, Xiajing, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
  • Yu, Zanzhe, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
  • Zhou, Yijun, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
  • Gu, Leyi, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
  • Ni, Zhaohui, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
Background

Hyperkalemia is a common and life-threatening electrolyte disorder. However, data on hyperkalemia burden in China especially its relationship to clinical outcome in real-world patients remain limited. We conducted a retrospective cohort study to investigate the prevalence, recurrence and prognosis of hyperkalemia in a large tetertiary hospital in China.

Methods

Patients aged ≥18 years who had at least one serum potassium measurement from January 2018 to December 2021 in a large tetertiary hospital in China were enrolled and followed up until April 2022.The primary endpoint was the proportion of patients who experienced a hyperkalemia event (serum potassium [sK] >5.0 mmol/L). Secondary endpoints included the proportion of patients who experienced hyperkalemia recurrence and all-cause mortality rate in patients with hyperkalemia. Risk factors associated with all-cause death in patients with hyperkalemia were analyzed using logistic regression (exploratory).

Results

A total of 55,288 patients were enrolled (median age: 54.0 years; 44.0% were male).Overall, 1131 patients(2.1%)experienced hyperkalemia (428 [0.8%] had sK >5.5 mmol/L and 167 [0.3%] had sK >6.0 mmol/L). 73.2% of patients with hyperkalemia were first diagnosed in the emergency department. Besides, hyperkalemia recurrence occurred in 12.4% patients during the 30 days follow-up, among them 6.6% patients recurred in 7 days. The 1-, 2-, 3- and 4-year all-cause mortality rates in patients with hyperkalemia were 18.5%, 19.5%, 19.9% and 20.2%. Risk factors for all-cause death were serum potassium level(per 1 mmol/L increase) [HR: 1.328, 95%CI:1.033-1.078,p=0.027] and hemoglobin lever(per 1g/dL) [HR:2.027, 95%CI: 1.460-2.815,p<0.01].

Conclusion

Hyperkalemia was common in real-world patients in China with relatively high recurrence and poor prognosis. In fact, hyperkalemia is not only considered as an occasional one-time critical event, but also affects long-term outcome and required continuous management.

Figure 1. The all-cause mortality rates in patients with hyperkalemia.