Health-Related Quality of Life Impaired in Patients with Hyperkalemia

Patients with chronic kidney disease (CKD) have impaired health-related quality of life and are at increased risk for hyperkalemia. Susan Grandy, PhD, and colleagues conducted an analysis to examine the impact of hyperkalemia on health-related quality of life and identify recommendations for lifestyle changes in patients with CKD and hyperkalemia. Results of the analysis were reported online in the International Journal of Clinical Practice [doi.org/10.1111.ijcp.14326].

The analysis utilized data from the Adelphi Real World Chronic  Kidney Disease Specific Programme™. Data were collected from clinicians and patients with non-dialysis dependent stage 3a, 3b, and 4 CKD in the United States, France, Germany, Spain, Italy, the United Kingdom, and China. Patients completed the Kidney Disease Quality of Life (KDQOL) questionnaire and the EuroQol-5D-3L. The analysis compared data between patients with hyperkalemia (serum potassium >5.0 mmol/L) and those without hyperkalemia (serum potassium 3.5-5.0 mmol/L).

A total of 1149 patients (US, n=376; Europe, n=490; China, n=283) were included in the analysis. Of the 1149 patients, 216 had hyperkalemia and 933 did not. Patients with hyperkalemia experienced more symptoms than patients without hyperkalemia (P<.001). Patients in the hyperkalemia group also had numerically lower scores, indicating poorer health-related quality of life, in all domains on the KDQOL questionnaire. The differences between the two groups were significant in three of the five domains. Patients in the hyperkalemia group reported numerically lower EuroQol-5D-3L utility index and Visual Analogue scores, indicating poorer health status, than patients without hyperkalemia.

Reduction of dietary potassium was recommended for a higher proportion of patients in the hyperkalemia group compared with the group without hyperkalemia (P<.05). Of the six recommended lifestyle changes, more patients in the group without hyperkalemia reported making a change in five of those recommendations. For four of the six recommendations, the differences in numbers of patients making changes were significant between the hyperkalemia group and the group without hyperkalemia.

In conclusion, the researchers said, “Hyperkalemia is associated with an incremental impairment of the health-related quality of life in chronic kidney disease patients. Better understanding of the impact of hyperkalemia in these patients could improve patient outcomes.”