Hyperkalemia-related hospitalizations result in higher-than-average costs and readmission rates in the 12 months after discharge, a new study finds.  

Using the IBM MarketScan Commercial and Medicare-Supplemental Claims database 2010 to 2014, investigators identified and compared 4426 pairs of patients with and without a hyperkalemia-related hospitalization who were matched by age, chronic kidney disease stage, heart failure status, dialysis treatment, use of renin angiotensin aldosterone system inhibitors, and major diagnostic categories.

The mean cost of a hyperkalemia-related hospitalization was $30,339 higher in the 12 months after discharge ($68,861 vs $38,482) and led to significantly more inpatient admissions (1.0 vs 0.4), emergency department visits (2.0 vs 1.2), and outpatient visits (49.6 vs 39.1) than a nonhyperkalemia hospitalization (all P <.001), Fan Mu, MBBS, PhD, of Analysis Group, Inc. in Boston, Massachusetts, and colleagues reported in Kidney International Reports.

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Patients hospitalized with hyperkalemia had significantly higher readmission rates within 30 days (0.15 vs 0.09), 60 days (0.25 vs. 0.16), and 90 days (0.36 vs 0.23) than patients with unrelated hospitalizations (all P <.001). They also had a longer length of stay per readmission (8.1 vs 7.1 days) and more total inpatient days (10.5 vs 5.8 days); all P <.001. Similar trends were observed across comorbidity subgroups, such as patients with CKD stage 4, hypertension, diabetes, or dialysis.

“The high incremental postdischarge economic and readmission burdens may be attributable to lack of monitoring and the absence of outpatient treatment following discharge,” Dr Mu’s team stated. “Close monitoring and timely treatment after discharge from a hyperkalemia-related hospitalization should be considered and may help to reduce the economic burden, particularly among patients who are at a high risk of recurrence.”

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


Betts KA, Woolley JM, Mu F, et al. Postdischarge health care costs and readmission in patients with hyperkalemia-related hospitalizations. Kidney Int Rep. 5:1280–1290. doi:10.1016/j.ekir.2020.06.004