Patients with stage 3 to 4 chronic kidney disease (CKD) commonly experience hyperkalemia, and certain factors are associated with increased risk of the condition, according to new study findings presented at the European Renal Association-European Dialysis and Transplant Association’s 56th Congress in Budapest, Hungary.

Of 150 patients with stage 3 to 4 CKD from his institution, 26% had hyperkalemia (serum potassium 5.5 mEq/L or higher) during a 6-month period, Mahmud Javed Hasan, MD, of Community Based Medical College Bangladesh, Mymensingh, reported. The life-threatening electrolyte abnormality appeared more prominent in later stages, occurring in 20.5%, 38.5%, and 41%, of those with stage 3a, 3b, and 4 CKD, respectively.

Investigators observed several significant differences by potassium status. A majority of hyperkalemic patients were female (71.8%), whereas most normokalemic patients were male (73%). Hyperkalemia patients had lower mean body mass index (BMI; 21.4 vs 22.7 kg/m2), serum calcium (6.4 vs 7.1 mg/dL), and serum albumin (2.7 vs 3.2 mg/dL). However, mean age (49.7 vs. 43.6 years), serum creatinine (2.1 vs 1.9 mg/dL), serum potassium (5.8 vs 4.9 mEq/L), and serum phosphate (5.8 vs 5.2 mg/dL) were higher in the hyperkalemia group.

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Common comorbidities did not account for between-group differences. Diabetes, hypertension, dyslipidemia, coronary heart disease, congestive heart failure, and malignancy occurred in similar proportions of both groups.

Significantly more hyperkalemia patients used renin-angiotensin-aldosterone system (RAAS) inhibitors, sodium bicarbonate, and sodium polystyrene sulphonate, however. In multivariate analyses, female sex, age older than 45, serum phosphate exceeding 4.5 mg/dL, and use of RAAS blockers independently predicted hyperkalemia.

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Hasan MJ. Prevalence and determinants of hyperkalemia in patients with Stage 3-4 CKD. Presented at the European Renal Association-European Dialysis and Transplant Association 56th Congress in Budapest, Hungary. Abstract FP438.