Abstract: SA-PO0509
Development of a Nomogram for Predicting Hyperkalemia in Advanced CKD
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical - 3
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolytes, and Acid-Base Disorders
- 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Chavez, Jonathan, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Garcia-Garcia, Guillermo, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Navarro Blackaller, Guillermo, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Medina, Ramon, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Mendoza Gaitán, Héctor Eduardo, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico
- Martínez Gallardo González, Alejandro, Hospital Civil de Guadalajara, Guadalajara, Jal., Mexico
- Joachin, Emerson, AstraZeneca SA de CV, Mexico City, CDMX, Mexico
- Alcantar Vallin, Maria de la Luz, Universidad de Guadalajara, Guadalajara, Jal., Mexico
- Gómez Fregoso, Juan, Universidad de Guadalajara, Guadalajara, Jal., Mexico
Background
With advanced chronic kidney disease (CKD) develop hyperkalemia (HyperK) is frequent. Predicting HyperK is important if we are to prevent it, identify it early, and treat it. We developed a nomogram to predict HyperK in advanced CKD.
Methods
In a retrospective cohort study we included ambulatory persons with advanced CKD without HyperK in order to differentiate between clinical presentations and the association with HyperK, death, and kidney replacement therapy (KRT). We analyzed risk using logistic regression with lasso and a multivariate Cox proportional hazards model and created a simple nomogram to predict HyperK according to sex.
Results
Between 2020 and 2024, 395 patients with advanced CKD. Women (49.4%), mean age was 65 years. The main comorbidities were diabetes (57%) and hypertension (74.9%). The mean GFR 25 ml. 80% were taking RAASi and 60% diuretics. During the 2.2-year follow-up 76% developed HyperK. The risk of HyperK fell by 49% in men (OR, 0.51; CI, 0.28-0.92) and 58% in patients taking thiazides (OR, 0.42; CI, 0.21-0.86). Given that the risk of HyperK differed according to sex, we ran separate models for women and men. In women, the risk of HyperK fell by 60% in the case of obesity (OR, 0.40; CI, 0.19-0.87) and 61% in line with sodium values (OR, 0.39; CI, 0.17-0.91). The area under the receiver operating characteristic curve was 0.703 for women and 0.731 for men. We constructed a nomogram that predicted HyperK in both sexes with a high degree of accuracy. 29 patients (7%) died, KRT was initiated in 73 patients (18.4%).
Conclusion
We developed a nomogram based on simple clinical characteristics to evaluate the risk of HyperK in advanced CKD.
Funding
- Commercial Support – Astrazeneka