Factors for increased risk of hyperkalemia include ethnicity, age, gender
Click Here to Manage Email Alerts
In addition to being male and of older age, being Black or Hispanic can increase a patient’s risk for hyperkalemia recurrence within 1 year of a hyperkalemia event, according to data presented at ASN Kidney Week.
“Hyperkalemia (HK) is associated with and directly increases morbidity and mortality. Hyperkalemia is often asymptomatic and if left unidentified, not monitored, and untreated, it may result in sudden death,” Rebecca S. Ahdoot, MD, assistant clinical professor at University of California Irvine School of Medicine, told Healio. “Identifying risk factors associated with recurrence of hyperkalemia including race and ethnicity would provide great insight and guidance on frequency of monitoring and ultimately minimize unfavorable outcomes.”
“We sought to examine factors associated with HK recurrence among the U.S. veteran population,” Elani Streja, MPH, PhD, health science specialist at Tibor Rubin VA Medical Center in Long Beach, California and assistant professor at University of California Irvine Medical Center in Orange, California, told Healio.
Streja and colleagues used the Fine and Gray competing risk regression model to assess potential demographic predictors of 1-year HK reoccurrence in a cohort of 2,457,498 U.S. veterans who experienced a HK event (sK >5 mEq/L) between 2004 and 2018. The competing event was defined as all-cause mortality within 1 year following the index HK event.
“We defined HK recurrence as the third or later potassium measurement after the index HK measurement, and patients need to have at least one or more normal potassium measurements (5 mEq/L) between the HK events,” Streja and colleagues wrote.
Among the cohort, the mean age was 63±13years, the mean index potassium level was 5.31±0.29 mEq/L, and median (IQR) index eGFR was 68 mL/min/1.73 m2. Additionally, 96% of the cohort were male, 13% were Black and 6% were Hispanic.
Researchers determined that 17% of participants experienced a HK recurrence within 1 year following the index HK occurrence.
Results revealed Black participants had a 19% higher risk of 1-year HK recurrence compared with white participants. Compared with non-Hispanic participants, Hispanic participants had a 34% higher risk of 1-year HK recurrence.
Older age and being male were other predictors for high risk of 1-year HK recurrence (15% higher for each 15-year increment of age; 22% higher compared with women).
“We noted that there is limited information on the association of race/ethnicity and HK recurrence. Prior studies in patients with CKD have shown that Black Americans have lower serum potassium levels than white patients. Additional studies have shown that associations between serum potassium and mortality differ according to race, showing that Black and Hispanic patients have lower risk of death pointing to a potential better tolerance of HK,” Kam Kalantar-Zadeh, MD, MPH, PhD, chief of the division of nephrology, hypertension and kidney transplantation, and tenured professor of medicine, pediatrics, public health and nursing sciences at the University of California Irivine School of Medicine, told Healio. “This is the first study to examine race/ethnicity impacts on hyperkalemia recurrence. Examination of underlying causes for these differences and considerations for appropriate management of hyperkalemia according to race/ethnicity and in consideration of social and dietary impacts are needed.”
Collapse
Streja E, et al. Abstract PO2329. Presented at: ASN Kidney Week; Nov. 4-7, 2021 (virtual meeting).
Read more about
Click Here to Manage Email Alerts