Progression Rates of Hyperkalemia Increase with CKD Stage

Researchers, led by Rubeen K. Israni,
MD, recently conducted a study among people with mild hyperkalemia to
identify the time to progression from mild hyperkalemia to moderate-to-severe
or severe hyperkalemia. Results were reported during a poster session at Kidney
Week 2019 in a poster titled Hyperkalemia Progression Rates among Patients
with Mild Hyperkalemia.

The researchers examined data from
electronic health records from the Research Action for Health Network (2012-2018).
Eligible patients had a minimum of one mild hyperkalemia event, defined as
serum potassium >5.0 and ≤5.5 mEq/L. 
The index date was defined as the date of the first mild hyperkalemia
event. Patients had to have a minimum of one additional serum potassium
laboratory value during the study period (2 years post-index date).

Progression to moderate-to-severe
hyperkalemia and to severe hyperkalemia was defined as the first occurrence of
a serum potassium laboratory value >5.5 mEq/L and >6.0 mEq/L,
respectively. Rates of progression over the study period for the overall study
population were estimated using Kaplan-Meier analyses. Analyses were also
performed among patient subgroups, including patients with and without chronic
kidney disease (CKD stages 3-5), heart failure, hypertension, or type 2
diabetes.

The analysis included 35,369 patients
with mild hyperkalemia. Mean age of the cohort was 65.6 years and 47.5% were
women. At the end of the study period, 16.9% of patients progressed to
moderate-to-severe hyperkalemia and 8.7% progressed to severe hyperkalemia.
Among the subgroups, rates of hyperkalemia progression were higher in patients
with CKD, heart failure, hypertension, and diabetes compared with patients
without those conditions (all log-rank P<.001). As CKD stage
progressed, there were significant increases in the rate of hyperkalemia
progression (P<.001).

In conclusion, the researchers said,
“A total of 16.9% of patients with mild hyperkalemia experienced hyperkalemia
progression during the 2-year follow-up period. Hyperkalemia progression rates
increased significantly with CKD stage and were also higher among those with
heart failure, hypertension, or type 2 diabetes.”

Source: Israni RK, David J, Betts K,
et al. Hyperkalemia progression rates among patients with mild hyperkalemia.
Abstract of a poster presented at the American Society of Nephrology Kidney
Week 2019 (Abstract FR-PO648), November 8, 2019, Washington, DC.