PUK3 - Epidemiology of Chronic Kidney Disease and Predictors of Hyperkalemia: Analysis of Nhanes 2007–2014

Abstract

Chronic kidney disease (CKD) is progressive condition characterizing the gradual loss of kidney function. Patients with CKD are at high risk for hyperkalemia, which can cause severe cardiac electrophysiology alterations and sudden death. The objective of this study was to describe the prevalence of CKD among US adults and identify predictors of hyperkalemia among CKD patients during the time period 2007 to 2014. This was a cross-sectional analysis of 24,732 nationally representative adults ages 18+ years from the US National Health and Nutrition Examination Survey (NHANES) collected during 2007-2014. CKD prevalence and severity were estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Univariate logistic regression analyses were conducted to determine significant predictors of hyperkalemia among CKD patients. The prevalence of CKD among US adults decreased from 18.10% in 2007–2008 to 16.77% in 2013–2014 (p=0.004). Overall, the prevalence of CKD from 2007–2014 was 16.74%, 46.05% of whom were stages 3–5. The average age of CKD patients decreased from 62.45 ± 17.35 years in 2007–2008 to 60.58 ± 17.67 years in 2013–2014 (p=0.002). Hyperkalemia was present in 4.75% of stage 3 patients, 14.09% of stage 4 patients, and 23.29% of stage 5 patients. Significant predictors of hyperkalemia among all patients with CKD included congestive heart failure (OR=2.79; 95% CI=1.82–4.27), diabetes (OR=2.19; 95% CI=1.54–3.10), and male sex (OR=1.69; 95% CI=1.19–2.41). This study shows that CKD is a serious problem in the US, affecting over 40 million adults. Nearly half of these patients suffer from more severe, later-stage CKD. The prevalence of hyperkalemia among CKD patients increased with increasing CKD severity, affecting nearly one-fourth of stage 5 patients. CKD patients with comorbidities such as heart failure or diabetes are at greatest risk of developing hyperkalemia.