Elevated Potassium Raises Death Risk in Critically Ill Patients

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LAS VEGAS—Even modest rises in serum potassium at critical care initiation is a significant predictor of all-cause mortality, according to researchers at Brigham and Women's Hospital in Boston.

Gearoid M. McMahon, MD, and colleagues at Brigham and Women's Hospital in Boston, performed an observational study of 39,705 critically ill adult patients. They looked at the highest potassium levels on the day of critical care initiation.

The risk of death increased along with increasing potassium levels. Compared with patients who had potassium levels of 4.0-4.5 mEq/L, those with levels of 4.5-5.0, 5.0-5.5, 5.5-6.0, 6.0-6.5, and greater than 6.5 had a significant 25%, 44%, 75%, 76% and 84% increased risk of 30-day mortality, respectively, the researchers reported at the National Kidney Foundation Spring Clinical Meetings. The results were similarly significant for 90-day and 365-day mortality.

“Our findings suggest that a sizable proportion of critically ill patients have hyperkalemia on ICU admission,” the authors concluded. “In this study, the specific characteristics that are associated with hyperkalemia included sepsis, increased creatinine, hyperglycemia, and acute kidney injury.”

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