Abstract
BackgroundHyperkalemia is a serious life-threatening condition that leads to significant morbidity and mortality.ObjectivesThe aim of this study is to investigate the association between the duration and outcomes in patients hospitalized with hyperkalemia, as well as associated risk factors and drug-induced hyperkalemia.MethodsA three-year retrospective chart review study was conducted at a tertiary hospital at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between January 2016 and April 2019. We included all hospitalized adults and patients with hyperkalemia. Pediatric patients and dialysis patients with end-stage renal failure were excluded.ResultsOut of a total of 300 hospitalized patients who were screened for hyperkalemia, only 142 patients were included. The majority of cases were males (56.3%), whereas 43.7% were females. Most patients were above 55 years old. Regarding comorbidities in patients with hyperkalemia, most of them suffered from high blood pressure or diabetes. The mean serum potassium value was 5.7 ± 0.51 mEq. The most frequent medications used in the study population were azole antifungal medication followed by nonsteroidal anti-inflammatory drugs, beta-blockers, and angiotensin-converting enzyme inhibitors. Around 54 patients were not treated with medication and were monitored for spontaneous correction of hyperkalemia. Insulin was the most used medication for the treatment of hyperkalemia. The mean duration for the resolution of hyperkalemia was 12 ±9.4 hours. Out of 142 patients, only 10 (7%) patients died with hyperkalemia.ConclusionsHospitalized patients are at risk of hyperkalemia. In our study, we found that patients who had hyperkalemia were significantly likely to have acute kidney injury or cardiovascular diseases, and azole antifungals and beta-blockers were the most commonly used medications.
Highlights
Serum potassium plays multiple critical roles and is essential for normal cardiac, nervous, and muscular functions
The most frequent medications used in the study population were azole antifungal medication followed by nonsteroidal anti-inflammatory drugs, beta-blockers, and angiotensin-converting enzyme inhibitors
We found that patients who had hyperkalemia were significantly likely to have acute kidney injury or cardiovascular diseases, and azole antifungals and beta-blockers were the most commonly used medications
Summary
Serum potassium plays multiple critical roles and is essential for normal cardiac, nervous, and muscular functions. Several homeostatic factors keep serum potassium within a narrow range, such as insulin, aldosterone, β-adrenergic receptors, and blood pH. Any irregularity in these factors can result in hypo- or hyperkalemia [1]. Hyperkalemia is associated with life-threatening cardiac dysrhythmias and arrest, which significantly increase morbidity and all-cause mortality [3,4,5]. The time until the resolution of hyperkalemia has been found to be significantly associated with in-hospital mortality, with an incidence of 1.1 to 10 patients per 100 admitted patients [5,6]. Hyperkalemia is a serious life-threatening condition that leads to significant morbidity and mortality
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