Severe hyperkalaemia: demographics and outcome

Area of Science:

• Nephrology
• Internal Medicine
• Biochemistry

Background:

• Limited data exists on severe hyperkalaemia prevalence in general patient populations.
• This study aimed to determine prevalence, patient characteristics, and outcomes of severe hyperkalaemia.
• Junior doctor knowledge on severe hyperkalaemia was also assessed.

Purpose of the Study:

• To determine the prevalence of severe hyperkalaemia (K≥ 6.5 mmol/L) in an unselected patient population.
• To describe patient demographics, clinical management, and outcomes associated with severe hyperkalaemia.
• To evaluate the understanding of trainee doctors regarding severe hyperkalaemia.

Main Methods:

• Retrospective analysis of biochemical laboratory data for severe hyperkalaemia episodes in 2011.
• Patient data including demographics, comorbidities (CKD stages, AKI), and nephrology care were reviewed.
• A structured questionnaire assessed trainee doctors' knowledge of severe hyperkalaemia.

Main Results:

• Severe hyperkalaemia occurred in 0.11% of patients (433 samples, 365 patients).
• Episodes were more common in patients with chronic kidney disease (CKD) and/or acute kidney injury (AKI), often not under nephrology care.
• Higher acute mortality was observed in the non-nephrology cohort, and trainee doctors demonstrated knowledge deficiencies.

Conclusions:

• Severe hyperkalaemia is uncommon, primarily affecting patients with CKD and/or AKI.
• A significant proportion of severe hyperkalaemia cases occur in patients not managed by nephrologists.
• Variability in care and knowledge gaps among junior doctors necessitate educational interventions.