Hyperkalemia in hospitalized patients

M. S. Stevens, Robert W. Dunlay

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Objective: Evaluate the prevalence of hyperkalemia (potassium > 5.5 mmol/l) in hospitalized patients not on dialysis, as well as the association of medications, impaired renal function and comorbid conditions with hyperkalemia. Design: A retrospective case-control method. Setting: A tertiary care teaching hospital. Patients: Hyperkalemic adults not on dialysis with age and sex matched controls. Interventions: None. Main outcome measures: The use of medications associated with hyperkalemia and renal function using a calculated creatinine clearance were compared in the hyperkalemic and control groups. Results: 35 adult patients with hyperkalemia who were not receiving dialysis were identified, with a prevalence in the hospitalized population of 3.3%. The hyperkalemic patients were older than the general hospital population (p <0.05). Compared with controls, hyperkalemic patients: had a lower creatinine clearance (p <0.05), were more likely to be taking angiotensin-converting enzyme inhibitors (p <0.05), and had an increased frequency of diabetes mellitus (p <0.001). All of the control patients survived their hospitalization, but the mortality rate in the hyperkalemic group was 17% (p <0.0001). None of the deaths were directly attributable to hyperkalemia. Conclusions: Hyperkalemia is more frequent in older patients and is usually mild. Hyperkalemia is associated with diabetes mellitus, diminished renal function and the use of angiotensin-converting enzyme inhibitors. An elevated serum potassium level in a hospitalized patient may be a marker for a significantly increased risk of death, which is due to underlying medical problems and is not a consequence of the hyperkalemia.

Original languageEnglish
Pages (from-to)177-180
Number of pages4
JournalInternational Urology and Nephrology
Volume32
Issue number2
DOIs
StatePublished - 2000

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Hyperkalemia
Dialysis
Kidney
Angiotensin-Converting Enzyme Inhibitors
Creatinine
Diabetes Mellitus
Potassium
Tertiary Healthcare
Teaching Hospitals
General Hospitals
Population
Hospitalization
Outcome Assessment (Health Care)
Control Groups
Mortality
Serum

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Urology
  • Geriatrics and Gerontology

Cite this

Hyperkalemia in hospitalized patients. / Stevens, M. S.; Dunlay, Robert W.

In: International Urology and Nephrology, Vol. 32, No. 2, 2000, p. 177-180.

Research output: Contribution to journalArticle

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abstract = "Objective: Evaluate the prevalence of hyperkalemia (potassium > 5.5 mmol/l) in hospitalized patients not on dialysis, as well as the association of medications, impaired renal function and comorbid conditions with hyperkalemia. Design: A retrospective case-control method. Setting: A tertiary care teaching hospital. Patients: Hyperkalemic adults not on dialysis with age and sex matched controls. Interventions: None. Main outcome measures: The use of medications associated with hyperkalemia and renal function using a calculated creatinine clearance were compared in the hyperkalemic and control groups. Results: 35 adult patients with hyperkalemia who were not receiving dialysis were identified, with a prevalence in the hospitalized population of 3.3{\%}. The hyperkalemic patients were older than the general hospital population (p <0.05). Compared with controls, hyperkalemic patients: had a lower creatinine clearance (p <0.05), were more likely to be taking angiotensin-converting enzyme inhibitors (p <0.05), and had an increased frequency of diabetes mellitus (p <0.001). All of the control patients survived their hospitalization, but the mortality rate in the hyperkalemic group was 17{\%} (p <0.0001). None of the deaths were directly attributable to hyperkalemia. Conclusions: Hyperkalemia is more frequent in older patients and is usually mild. Hyperkalemia is associated with diabetes mellitus, diminished renal function and the use of angiotensin-converting enzyme inhibitors. An elevated serum potassium level in a hospitalized patient may be a marker for a significantly increased risk of death, which is due to underlying medical problems and is not a consequence of the hyperkalemia.",
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AB - Objective: Evaluate the prevalence of hyperkalemia (potassium > 5.5 mmol/l) in hospitalized patients not on dialysis, as well as the association of medications, impaired renal function and comorbid conditions with hyperkalemia. Design: A retrospective case-control method. Setting: A tertiary care teaching hospital. Patients: Hyperkalemic adults not on dialysis with age and sex matched controls. Interventions: None. Main outcome measures: The use of medications associated with hyperkalemia and renal function using a calculated creatinine clearance were compared in the hyperkalemic and control groups. Results: 35 adult patients with hyperkalemia who were not receiving dialysis were identified, with a prevalence in the hospitalized population of 3.3%. The hyperkalemic patients were older than the general hospital population (p <0.05). Compared with controls, hyperkalemic patients: had a lower creatinine clearance (p <0.05), were more likely to be taking angiotensin-converting enzyme inhibitors (p <0.05), and had an increased frequency of diabetes mellitus (p <0.001). All of the control patients survived their hospitalization, but the mortality rate in the hyperkalemic group was 17% (p <0.0001). None of the deaths were directly attributable to hyperkalemia. Conclusions: Hyperkalemia is more frequent in older patients and is usually mild. Hyperkalemia is associated with diabetes mellitus, diminished renal function and the use of angiotensin-converting enzyme inhibitors. An elevated serum potassium level in a hospitalized patient may be a marker for a significantly increased risk of death, which is due to underlying medical problems and is not a consequence of the hyperkalemia.

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