{"id":2478,"date":"2021-05-27T00:00:00","date_gmt":"2021-05-27T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/initial-and-recurrent-hyperkalemia-events-in-patients-with-ckd-in-older-adults-a-population-based-cohort-study\/"},"modified":"2023-06-14T19:18:43","modified_gmt":"2023-06-14T23:18:43","slug":"initial-and-recurrent-hyperkalemia-events-in-patients-with-ckd-in-older-adults-a-population-based-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/initial-and-recurrent-hyperkalemia-events-in-patients-with-ckd-in-older-adults-a-population-based-cohort-study\/","title":{"rendered":"Initial and recurrent hyperkalemia events in patients with CKD in older adults: a population-based cohort study"},"content":{"rendered":"

Background <\/strong>— The risk of hyperkalemia is elevated in chronic kidney disease (CKD); however, the initial and recurrent risk among older individuals is less clear.<\/p>\n

Objectives <\/strong>— We set out to examine the initial and 1-year recurrent risk of hyperkalemia by level of kidney function (estimated glomerular filtration rate, eGFR) in older adults (≥66 years old).<\/p>\n

Design <\/strong>— Population-based, retrospective cohort study<\/p>\n

Settings <\/strong>— Ontario, Canada<\/p>\n

Participants <\/strong>— 905 167 individuals (≥66 years old) from 2008 to 2015.<\/p>\n

Measurements <\/strong>— Serum potassium values<\/p>\n

Methods <\/strong>— Individuals were stratified by eGFR (≥90, 60-89, 30-59, 15-29 mL\/min\/1.73 m2) and examined for the risk of incident hyperkalemia (K ≥ 5.5 mEq\/L) using adjusted Cox proportional hazards models. The 1-year risk of recurrent hyperkalemia was examined using multivariable Andersen-Gill models.<\/p>\n

Results <\/strong>— Among a population of 905 167 individuals (15% eGFR ≥ 90, 58% eGFR 60-89, 25% eGFR 30-59, 3% eGFR 15-29) with a potassium measurement, there were a total of 18 979 (2.1%) individuals with hyperkalemia identified. The event rate (per 1000 person-years) and adjusted hazard ratio (HR) of hyperkalemia was inversely associated with eGFR (mL\/min; eGFR >90 mL\/min: 8.8, referent, 60-89 mL\/min: 11.8 HR 1.41; eGFR 30-59: 39.8, HR 4.37; eGFR 15-29: 133.6, 13.65) and with an increasing urine albumin-to-creatinine ratio (ACR, mg\/mmol; ACR< 3: 14, referent, ACR 3-30: 35.1, HR 1.98; ACR >30: 93.7, 4.71). The 1-year event rate and adjusted risk of recurrent hyperkalemia was similarly inversely associated with eGFR (eGFR ≥ 90: 10.1, referent, eGFR 60-89: 14.4, HR 1.47; eGFR 30-59: 54.8, HR 4.90; eGFR 15-29: 208.0, HR 12.98). Among individuals with a baseline eGFR of 30 to 59 and 15 to 29, 0.9 and 3.8% had greater than 2 hyperkalemia events. The relative risk of initial and recurrent hyperkalemia was marginally higher with RAAS blockade. Roughly 1 in 4 individuals with hyperkalemia required hospitalization the day of or within 30 days after their hyperkalemia event.<\/p>\n

Limitations <\/strong>— Limited to individuals aged 66 years and above.<\/p>\n

Conclusions<\/strong> — Patients with low eGFR are at a high risk of initial and recurrent hyperkalemia.<\/p>\n","protected":false},"excerpt":{"rendered":"

Background — The risk of hyperkalemia is elevated in chronic kidney disease (CKD); however, the initial and recurrent risk among older individuals is less clear. Objectives — We set out to examine the initial and 1-year recurrent risk of hyperkalemia by level of kidney function (estimated glomerular filtration rate, eGFR) in older adults (≥66 years […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-2478","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Sriperumbuduri S, McArthur E, Hundemer GL, Canney M, Tangri N, Leon SJ, Bota S, Bugeja A, Akbari A, Knoll G, Sood MM. Can J Kidney Health Dis<\/em>. 2021; 8:1-11. Epub 2021 May 27.","source_url":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20543581211017408?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&","ices_scientist":[1264,20606],"site":[6739],"research_program":[6743],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"4CA2CB0F-8D0C-41A8-8D3F-01172900C7CA","sitecore_item_name":"Initial-and-recurrent-hyperkalemia-events-in-patients-with-CKD-in-older-adults","sitecore_field_values":"{\n \"Title\": \"Initial and recurrent hyperkalemia events in patients with CKD in older adults: a population-based cohort study\",\n \"Short title\": \"Initial and recurrent hyperkalemia\",\n \"Summary\": \"The risk of hyperkalemia is elevated in chronic kidney disease (CKD); however, the initial and recurrent risk among older individuals is less clear.\",\n \"Citation\": \"

Sriperumbuduri S, McArthur E, Hundemer GL, Canney M, Tangri N, Leon SJ, Bota S, Bugeja A, Akbari A, Knoll G, Sood MM. Can J Kidney Health Dis<\/em>. 2021; 8:1-11. Epub 2021 May 27. DOI: https:\/\/doi.org\/10.1177\/20543581211017408<\/a><\/p>\",\n \"Abstract\": \"

Background <\/strong>— The risk of hyperkalemia is elevated in chronic kidney disease (CKD); however, the initial and recurrent risk among older individuals is less clear.<\/p>n

Objectives <\/strong>— We set out to examine the initial and 1-year recurrent risk of hyperkalemia by level of kidney function (estimated glomerular filtration rate, eGFR) in older adults (≥66 years old).<\/p>n

Design <\/strong>— Population-based, retrospective cohort study<\/p>n

Settings <\/strong>— Ontario, Canada<\/p>n

Participants <\/strong>— 905 167 individuals (≥66 years old) from 2008 to 2015.<\/p>n

Measurements <\/strong>— Serum potassium values<\/p>n

Methods <\/strong>— Individuals were stratified by eGFR (≥90, 60-89, 30-59, 15-29 mL\/min\/1.73 m2) and examined for the risk of incident hyperkalemia (K ≥ 5.5 mEq\/L) using adjusted Cox proportional hazards models. The 1-year risk of recurrent hyperkalemia was examined using multivariable Andersen-Gill models.<\/p>n

Results <\/strong>— Among a population of 905 167 individuals (15% eGFR ≥ 90, 58% eGFR 60-89, 25% eGFR 30-59, 3% eGFR 15-29) with a potassium measurement, there were a total of 18 979 (2.1%) individuals with hyperkalemia identified. The event rate (per 1000 person-years) and adjusted hazard ratio (HR) of hyperkalemia was inversely associated with eGFR (mL\/min; eGFR >90 mL\/min: 8.8, referent, 60-89 mL\/min: 11.8 HR 1.41; eGFR 30-59: 39.8, HR 4.37; eGFR 15-29: 133.6, 13.65) and with an increasing urine albumin-to-creatinine ratio (ACR, mg\/mmol; ACR< 3: 14, referent, ACR 3-30: 35.1, HR 1.98; ACR >30: 93.7, 4.71). The 1-year event rate and adjusted risk of recurrent hyperkalemia was similarly inversely associated with eGFR (eGFR ≥ 90: 10.1, referent, eGFR 60-89: 14.4, HR 1.47; eGFR 30-59: 54.8, HR 4.90; eGFR 15-29: 208.0, HR 12.98). Among individuals with a baseline eGFR of 30 to 59 and 15 to 29, 0.9 and 3.8% had greater than 2 hyperkalemia events. The relative risk of initial and recurrent hyperkalemia was marginally higher with RAAS blockade. Roughly 1 in 4 individuals with hyperkalemia required hospitalization the day of or within 30 days after their hyperkalemia event.<\/p>n

Limitations <\/strong>— Limited to individuals aged 66 years and above.<\/p>n

Conclusions<\/strong> — Patients with low eGFR are at a high risk of initial and recurrent hyperkalemia.<\/p>n

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