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Abstract: TH-PO366

Predictors of EKG Changes in Hyperkalemia

Session Information

Category: Fluid, Electrolytes, and Acid-Base Disorders

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

Authors

  • Behgal, Jai, Staten Island University Hospital, Staten Island, New York, United States
  • Kalik, Salina, Staten Island University Hospital, Staten Island, New York, United States
  • Kwark, Michael, Staten Island University Hospital, Staten Island, New York, United States
  • Lather, Tanvi, Staten Island University Hospital, Staten Island, New York, United States
  • Asogwa, Nnedindu, Staten Island University Hospital, Staten Island, New York, United States
  • Ling, Joanne, Staten Island University Hospital, Staten Island, New York, United States
  • Wahbah Makhoul, Gennifer, Staten Island University Hospital, Staten Island, New York, United States
  • Grovu, Radu C., Staten Island University Hospital, Staten Island, New York, United States
  • El Sayegh, Suzanne E., Staten Island University Hospital, Staten Island, New York, United States
Background

Hyperkalemia can be potentially life-threatening in patients and calls for urgent intervention in a hospitalized setting. Typically, hyperkalemia is defined as serum potassium greater than 5 to 5.5 mEq/L. The incidence of hyperkalemia in hospitalized patients ranges from 1% to 10%. Studies have shown that the probability of electrocardiogram (ECG) changes increases with increasing serum potassium levels. ECG changes are also more common with acute, rapid changes of serum potassium and the concomitant presence of hypocalcemia and/or acidemia. In experimental settings, there appears to be a clear association between hyperkalemia and typical ECG abnormalities. However, in actual clinical practice, the relationship between potassium levels and ECG manifestations is less clear.

Methods

A partial database search and retrospective review of medical charts at Staten Island University Hospital between the years 2019-2022 was performed evaluating patients with hyperkalemia with potassium levels > 6.5 mEq/L. ECGs were reviewed to identify changes related to hyperkalemia. The presence or absence of certain variables, including demographics, electrolyte abnormalities, medications, and other co-morbidities were compared between the patients that had ECG changes and those that did not. We excluded patients with hemolyzed potassium samples and patients with baseline ECG changes. Univariate chi-square analysis and multivariate analysis were performed.

Results

One hundred forty-nine patients were identified that had admissions for non-hemolyzed hyperkalemia with serum potassium levels greater than 6.5 mEq/L, of which only 38 patients presented with EKG changes. There was no significant difference between patients with the presence or absence of CKD, ESRD, CHF, diabetes potassium-sparing diuretics, ACEs or ARBS, or patients admitted for rhabdomyolysis or acute coronary syndrome.

Conclusion

No significant predictors of ECG changes were identified in patients that had presented with hyperkalemia greater than 6.5 mEq/L between 2019-2022 at SIUH. The study may have been limited by the patient population. A larger patient population size may help identify predictors of ECG changes when hospitalized patients are admitted with hyperkalemia. Identifying these factors may potentially guide future treatment of hyperkalemia in the clinical setting.