Hyperkalemia: Epidemiology and contributing factors

<p>N. Sellami, H. Jebali, W. Smaoui, R. Kheder-Elfekih, I. Mami, M. Krid, L. Ben Fatma, S. Beji, L. Rais and MK. Zouaghi</p>

Hyperkalemia: Epidemiology and contributing factors

N. Sellami, H. Jebali, W. Smaoui, R. Kheder-Elfekih, I. Mami, M. Krid, L. Ben Fatma, S. Beji, L. Rais and MK. Zouaghi

La Rabta Hospital, Tunisia

: J Nephrol Ren Dis

Abstract

Background: Hyperkalemia is a situation that nephrologists frequently face. The aim of our study was to investigate its epidemiological characteristics and its contributing factors. Methods: This transversal study included all the cases of hyperkalemia (K+>5,5 mmol/l) we were asked to manage in our hospital during 6 months [Sept 2016–Mars 2017]. Results: We recorded 207 patients with elevated serum potassium(63% males). Patients were mostly treated in the emergency department (61%) and the cardio-vascular surgery department (11%). Mean age was 63,5 years [15- 93]. Among our patients, 46% had hypertension, 36% had diabetes and 62% had a chronic renal failure. Half of the patients had acute renal failure, caused by obstructive mechanisms in 17% of the cases. Thirty five patients (16,8%) were using renin-angiotensin system inhibitors. Mean serum potassium was 6,5 mmol/l [5,6-9,7]. Eighty five per cent of the patients had metabolic acidosis. Mean serum creatinine was 677 μmol/l [79-2360]. Electrocardiogram abnormalities were detected in 15% of the patients. All patients had a medical treatment of hyperkalemia and emergency hemodialysis was required for 128 patients (62%). Cardiorespiratory arrest happened in 7 cases (3%). Mean serum potassium was significally higher in patients with electrocardiogram abnormalities (p<10-3). Mean serum potassium was higher in patients under angiotensinconverting- enzyme inhibitor (p<0,05). There was no significant variation of serum potassium due to classical factors such as diabetes, acidosis, or renal failure. Conclusion: Hyperkalemia remains a life threatening situation that can be promoted by several factors, hence the importance of its early diagnosis and treatement.