Hyperkalemia a Predictor of Mortality in AKI Requiring Dialysis

Patients with acute kidney injury (AKI) that requires renal replacement therapy are at increased risk for mortality. Charles Kangitsi Kahindo, MD, and colleagues In the Democratic Republic of the Congo (DRC) conducted a study to examine predictors of mortality at initiation of hemodialysis in patients with AKI. Results were reported online in the International Journal of Nephrology [doi:10.1155/2022/7418955].

The single-center cohort survey assessed the clinical profile and survival rates of patients with AKI who were admitted to hemodialysis in the only hemodialysis center in Goma, North Kiva province (DRC). Data were collected from patients who underwent hemodialysis associated with AKI. The analysis included patient demographics, comorbidities, clinical presentation, laboratory tests, and mortality. The Kaplan-Meier curve was used to assess survival, and Cox regression was used to identify predictors of mortality.

The study cohort included 131 patients. Mean age was 43.69 years and 54.96% were male. The overall hemodialysis mortality rate was 25.19% (n=33).

In multivariate analysis, there were seven predictors of mortality in patients with stage 3 AKI who were admitted to hemodialysis: (1) age >60 years (adjusted hazard ratio [aHR], 15.89; 95% CI, 3.98-63.40; (2) traditional herbal medicine intake (aHR, 5.10; 95% CI, 2.10-12.38); (3) HIV infection (aHR, 5.55; 95% CI, 1.48-20.73): (4) anemia (aHR, 9.57; 95% CI, 2.08-43.87); (5) hyperkalemia (aHR, 6.23; 95% CI, 1.26-30.72); (6) respiratory distress (aHR, 4.66; 95% CI, 2.07-10.50); and (7) coma (aHR, 11.39; 95% CI, 3.51-36.89).

“Initiation of hemodialysis with AKI has improved survival in patients with different complications,” the researchers said.