Half of patients with chronic kidney disease (CKD) experience hyperkalemia, and the more episodes they have, the more likely they are to have a recurrence, according to researchers presenting at the European Renal Association-European Dialysis and Transplant Association 2020 virtual congress.

Of 297,702 patients with stage 3 or higher CKD not on dialysis (mean age 75 years; 41% male) in the UK’s Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES) databases during 2008 to 2018, a total of 30.6% had resistant hypertension at diagnosis. Half of these patients were taking diuretics, 32.5% beta blockers, and 32.0% calcium channel blockers. Two-thirds eventually received a renin-angiotensin aldosterone system inhibitor (RAASi).

A total of 147,215 patients (49.5%) experienced at least 1 hyperkalemia event, including 36.5% with 1 episode, 63.5% with 2 or more episodes, and 20.0% with 6 or more episodes, Michael Hurst, PhD, of Health Economics and Outcomes Research in Cardiff, UK, and colleagues reported in Nephrology Dialysis Transplantation and during the conference. Having 1 hyperkalemia episode was associated with greater risk for a subsequent episode. The risk for recurrence increased from 49.5% for 1 episode to 63.5%, 70.7%, 74.1%, 76.5%, and 78.6% for patients experiencing 2, 3, 4, 5, and 6 episodes, respectively. With each recurrence, the time to the next event sped up.

“Frequent monitoring of serum potassium may help reduce the burden of [hyperkalemia] in patients with CKD,” Dr Hurst’s team stated.


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Disclosure: This clinical trial was supported by AstraZeneca. Please see the original reference for a full list of authors’ disclosures.

Reference

Hurst M, Hoskin L, Badora K, et al. Patterns of Hyperkalaemia recurrence among chronic kidney disease patients in UK clinical practice. Nephrol Dial Transplant. June 35(3). doi: 10.1093/ndt/gfaa142.P0683 Presented at the European Renal Association-European Dialysis and Transplant Association 2020 virtual congress. Abstract P0683.