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Severe hyperkalaemia: demographics and outcome

B M Phillips1, S Milner1, S Zouwail2

  • 1Insititute of Nephrology , Cardiff University School of Medicine , Cardiff , UK.

Clinical Kidney Journal
|April 9, 2015
PubMed

Insights

Severe hyperkalaemia, a condition of high potassium levels, affects 0.11% of patients, predominantly those with chronic kidney disease (CKD) or acute kidney injury (AKI). Educational initiatives are needed as junior doctors show knowledge gaps regarding its causes and management.

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.
Abstract

Keywords:
AKICKDhyperkalaemiapotassium

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