Predictors for repeated hyperkalemia and potassium trajectories in high-risk patients — A population-based cohort study

• DOI: 10.1371/journal.pone.0218739
• Publication Date: 2019-06-21T17:32:36Z
• Authors: Kasper Adelborg; Sia Kromann Nicol...; Pål Hasvold; Eirini Palaka; Lars Pedersen; Reimar Wernich Th...
• Keywords: Discontinuation

Understanding predictors and trajectories of increased potassium may inform testing treatment hyperkalemia. We examined for repeated hyperkalemia among patients after first-time renin angiotensin system inhibitor (RASi) prescription, chronic kidney disease (CKD), or heart failure (CHF); we also in these their first event. used Danish population-based registries to identify all with RASi incident CKD, CHF (2000–2012). For a event, over the following 6 months were examined. The associated assessed, defined as test >5.0 mmol/L event within months. Overall 262,375 users, 157,283 CKD patients, 14,600 included. Of occurred 37% 40% 49% CHF. Predictors included severe hyperkalemia, low eGFR, diabetes, spironolactone use. In cohorts, median levels declined 2–4 weeks time, but reverted higher than before initial those who had Following discontinuation was common cohorts. Repeated explored an indicator levels. likely benefit from intensified monitoring intervention.