{"id":22282,"date":"2025-07-29T13:58:25","date_gmt":"2025-07-29T17:58:25","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=22282"},"modified":"2025-08-19T15:55:20","modified_gmt":"2025-08-19T19:55:20","slug":"frequency-management-and-outcomes-of-outpatient-hyperkalemia","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/frequency-management-and-outcomes-of-outpatient-hyperkalemia\/","title":{"rendered":"Frequency, management, and outcomes of outpatient hyperkalemia: a population-based cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Hyperkalemia is a potentially life-threatening condition, with guidelines recommending urgent treatment when the serum potassium level is greater than 6.0 mmol\/L. However, these recommendations are inconsistent, leading to diverse approaches to patient care.<\/p>\n<p><strong>Objectives<\/strong> \u2014 The primary objectives were to use population-based datasets to determine how often outpatient hyperkalemia (K &gt; 6.2 mmol\/L) occurs and how frequently patients present to the emergency department (ED) within 24 hours of the hyperkalemia report. Secondary objectives were to compare the characteristics of patients who had an ED encounter to those who did not, assess clinical outcomes within 7 days of the hyperkalemia report, and describe the initial potassium result within 24 hours of an ED encounter.<\/p>\n<p><strong>Design<\/strong> \u2014 Retrospective cohort study using linked population-based datasets at ICES.<\/p>\n<p><strong>Setting<\/strong> \u2014 Ontario, Canada from January 1, 2007, to December 24, 2021.<\/p>\n<p><strong>Patients<\/strong> \u2014 Adult patients (\u226518 years) not on dialysis with an outpatient hyperkalemia result &gt;6.2 mmol\/L who were identified through flagged and urgently communicated results from outpatient laboratories.<\/p>\n<p><strong>Measurements<\/strong> \u2014 Emergency department encounters within 24 hours following an outpatient serum potassium report &gt;6.2 mmol\/L. Outcomes included all-cause mortality, cardiovascular mortality, arrhythmias, cardiac arrest in the ED, hospitalizations, and new dialysis starts within 7 days of the hyperkalemia report.<\/p>\n<p><strong>Methods<\/strong> \u2014 Administrative healthcare data were linked with laboratory results to compare baseline characteristics, medication use, healthcare utilization, and clinical outcomes for all patients. Standardized differences were used for comparisons.<\/p>\n<p><strong>Results<\/strong> \u2014 There were over 65 million serum potassium measurements and 57\u2009607 individuals with an outpatient hyperkalemia value &gt;6.2 mmol\/L. Of these, 7469 (13.0%) individuals had an ED encounter within 24 hours. Individuals with an ED encounter had more comorbidities, higher medication use, and more prior healthcare utilization. Within 7 days of the hyperkalemia report, 675 of the 57\u2009607 individuals (1.2%) had died. Where data were available, the first potassium value within 24 hours of an ED encounter was 1.5 mmol\/L (\u00b1 SD 1.3) lower, on average, than the initial outpatient potassium value.<\/p>\n<p><strong>Limitations<\/strong> \u2014 All-cause mortality may not be attributable to the hyperkalemia result. Sudden cardiac death, which is more specific to hyperkalemia, is not completely captured in our data sources. Data for medications are limited to patients 65 years of age and older.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Outpatient hyperkalemia is common. Despite guidelines recommending urgent treatment for patients with serum potassium levels &gt;6.2 mmol\/L, most are not referred to the ED.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Hyperkalemia is a potentially life-threatening condition, with guidelines recommending urgent treatment when the serum potassium level is greater than 6.0 mmol\/L. However, these recommendations are inconsistent, leading to diverse approaches to patient care. Objectives \u2014 The primary objectives were to use population-based datasets to determine how often outpatient hyperkalemia (K &gt; 6.2 mmol\/L) [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[49,35],"migration-helper-qa-sample-set":[],"class_list":["post-22282","journal_article","type-journal_article","status-publish","hentry","topic-kidney-disease","topic-public-health"],"acf":{"citation":"Chiu M, Jeyakumar N, Smith G, Nash DM, Abou El Hassan M, Bailey D, Catomaris P, Veljkovic K, Moist L, Garg AX, Jain AK. Frequency, Management, and Outcomes of Outpatient Hyperkalemia: A Population-Based Cohort Study. <em>Can J Kidney Health Dis.<\/em> 2025; 12:20543581251356568.","source_url":"https:\/\/doi.org\/10.1177\/20543581251356568","ices_scientist":[20188,1242,1280],"site":[6739],"research_program":[6743],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Frequency, management, and outcomes of outpatient hyperkalemia: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Background \u2014 Hyperkalemia is a potentially life-threatening condition, with guidelines recommending urgent treatment when the serum potassium level is\" \/>\n<meta name=\"robots\" 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