Hyperkalemia More Likely in Sicker Elderly Patients

As elderly patients age, the number of drugs they take that may cause hyperkalemia increases.
As elderly patients age, the number of drugs they take that may cause hyperkalemia increases.

Elderly patients with multiple co-morbid illnesses are at higher risk for hyperkalemia compared with those who have 1 or none, according to study findings presented at the European Renal Association-European Dialysis and Transplant Association 53rd Congress in Vienna.

The study also showed that use of non-steroidal anti-inflammatory drugs (NSAIDs), ACE inhibitors, angiotensin-receptor blockers (ARBs), and spironolactone are risk factors for hyperkalemia.

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Kenan Turgutalp, MD, of Mersin University in Mersin, Turkey, and colleagues studied 249 patients aged 65 years and older and suffering from community-acquired hyperkalemia (potassium level greater than 5.5 mEq/L). They divided patients into 4 groups: young-old (aged 65–74 years, group 1, 129 patients), middle-old (aged 75–84 years, group 2, 75 patients), oldest-old (aged 85 years and older, group 3, 45 patients), and a control group of 182 patients older than 65 years with potassium levels of 3.5–5.5 mEq/L.

The researchers found a positive correlation between age and the number of co-morbid diseases. In addition, as patients age, the number of drugs they take that may cause hyperkalemia increases.

Patients with 2 or more co-morbid illnesses had a 2.2-fold increased risk for hyperkalemia compared with patients who had fewer than 2. Women had a 2-fold increased risk compared with men. Use of NSAIDs, ACE inhibitors, ARBs, and spironolactone was associated with a 2.7, 2.4, 2.7, and 2.4 times increased risk for hyperkalemia compared with non-use of these medications.

The investigators found that serum potassium levels, mortality rates, and duration of hospitalization increased with age. The mean serum potassium levels were 5.96, 6.79, and 7.70 mEq/L in groups 1, 2, and 3, respectively. The mortality rates were 30.1%, 53.3%, and 65.8%, respectively. The duration of hospitalization was 6.21, 9.36, and 13.55 days, respectively.

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