Hyperkalemia prior to cardiac surgery is associated with adverse postoperative outcomes, investigators reported at the 56th European Renal Association-European Dialysis and Transplant Association congress in Budapest, Hungary.

In a study involving 3952 patients undergoing cardiac surgery at Shaare Zedek Medical Center in Jerusalem, Israel, Linda Shavit, MD, and colleagues found that preoperative hyperkalemia was associated with significant 1.9-, 3.0-, 2.8-, and 4.5-fold increased odds of postoperative mortality, cerebrovascular accidents, cardiac arrest, and need for dialysis, respectively, compared with normokalemia on multivariable analysis.

Preoperative hypokalemia was associated with significant 1.8-fold increased odds of low cardiac output.

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Abnormal preoperative potassium levels did not independently predict late survival, according to the investigators.

Dr Shavit’s team defined hyperkalemia as potassium levels 5 mEq/L or higher, normokalemia as potassium levels 3.5 mEq/L or higher but less than 5 mEq/L, and hypokalemia as levels below 3.5 mEq/L.

“Preoperative hyperkalemia is consistently associated with adverse postoperative outcomes in patients undergoing cardiac surgery,” the authors concluded in their study abstract. “Thus, appropriate preoperative evaluation and follow up is warranted in these patients. Whether outcomes could be improved by therapeutically targeting normokalemia prior to cardiac surgery remains to be determined.”


Shavit L, Offner E, Rachel T, et al. Preoperative potassium and outcomes of patients undergoing cardiac surgery. Presented at the European Renal Association-European Dialysis and Transplant Association 56th congress in Budapest, Hungary, June 13 to 16. Abstract FP109.