Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Elevated potassium levels in patients with chronic kidney disease: occurrence, risk factors and clinical outcomes-a Danish population-based cohort study

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. COLLAGEN TYPE III DEGRADATION IS ASSOCIATED WITH DETERIORATION OF KIDNEY FUNCTION IN PATIENTS WITH TYPE 2 DIABETES WITH MICROALBUMINURIA.

    Research output: Contribution to journalConference abstract in journalResearchpeer-review

  2. CORONARY ARTERIAL CALCIFICATION, ABDOMINAL AORTIC CALCIFICATION, AND PULSE WAVE VELOCITY IN DIALYSIS PATIENTS

    Research output: Contribution to journalConference abstract in journalResearchpeer-review

  3. DECREASES IN WEIGHT WITH BARDOXOLONE METHYL IN OBESE PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 4 AND TYPE 2 DIABETES - POST-HOC ANALYSES FROM BEACON

    Research output: Contribution to journalConference abstract in journalResearchpeer-review

  1. Temporal Regulation of Glomerular and Cortical Tubulointerstitial Genes Involved in the Development of Nephrotoxic Serum Nephritis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Autosomal dominant polycystisk nyresygdom

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Recidiverende ascites som den første præsentation af membranøs glomerulonefritis

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Reimar W Thomsen
  • Sia K Nicolaisen
  • Pål Hasvold
  • Ricardo Garcia Sanchez
  • Lars Pedersen
  • Kasper Adelborg
  • Kenneth Egstrup
  • Martin Egfjord
  • Henrik Toft Sørensen
View graph of relations

Background: Data on the true burden of hyperkalemia (HK) in patients with chronic kidney disease (CKD) in a real-world setting are scarce.

Methods: The incidence rate of HK [first blood test with an elevated blood potassium level level >5.0 mmol/L] in primary or hospital care was assessed in a population-based cohort of all newly diagnosed CKD patients [second estimated glomerular filtration rate (eGFR) measurement <60 mL/min/1.73 m 2 or hospital diagnosis] in northern Denmark. Risk factors and clinical outcomes were compared for CKD patients with HK and matched CKD patients without HK.

Results: Of 157 766 patients with CKD, 28% experienced HK, for an overall HK incidence rate of 70/1000 person-years. Among patients with Stage 3A, 3B, 4 or 5 CKD, 9, 18, 31 and 42%, respectively, experienced HK within the first year. Important HK risk factors included diabetes {prevalence ratio [PR] 1.74 [95% confidence interval (CI) 1.69-1.79]}, heart failure [PR 2.31 (95% CI 2.23-2.40)] and use of angiotensin-converting enzyme inhibitors [PR 1.45 (95% CI 1.42-1.48)], potassium supplements [PR 1.59 (95% CI 1.55-1.62)] or spironolactone [PR 2.53 (95% CI 2.44-2.63)]. In CKD patients who developed HK, 34% had any acute hospitalization 6 months before the HK event, increasing to 57% 6 months after HK [before-after risk ratio 1.72 (95% CI 1.69-1.74)]. The 6-month mortality following HK was 26%, versus 6% in matched non-HK patients. Compared with non-HK patients, 6-month hazard ratios for any acute hospitalization in HK patients were 2.11-fold higher, including hazard ratios of 2.07 for cardiac diagnoses, 2.29 for ventricular arrhythmias, 3.26 for cardiac arrest, 4.77 for intensive care and 4.85 for death.

Conclusions: More than one in four CKD patients develops HK. Patients with severe CKD, diabetes, heart failure or use of spironolactone are at high risk. HK is associated with severe clinical outcomes.

Original languageEnglish
JournalNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Volume33
Issue number9
Pages (from-to)1620
Number of pages1,620
ISSN0931-0509
DOIs
Publication statusPublished - 2018

    Research areas

  • Journal Article

ID: 52425241