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Prevalence, practice pattern, and mortality of hyperkalemia in Chinese patients undergoing hemodialysis in the

Zhao Xinju1, Xing Changying2, Liu Hong3

  • 1Department of Nephrology, Peking University People's Hospital, Unit 10C in Ward Building, 11 Xizhimennan Street, Xicheng District, Beijing, 100044, China.

Scientific Reports
|July 2, 2025
PubMed

Insights

Hyperkalemia (HK) affects 40.84% of Chinese hemodialysis (HD) patients, increasing mortality risks. Higher HK prevalence in HD centers correlates with greater patient deaths, indicating a need for better potassium management.

Area of Science:

  • Nephrology
  • Clinical Medicine
  • Public Health

Background:

  • Hyperkalemia (HK) is a common and serious complication in patients undergoing chronic hemodialysis (HD).
  • Understanding the prevalence, risk factors, and impact of HK on mortality is crucial for improving patient outcomes in HD centers.

Purpose of the Study:

  • To investigate the prevalence of HK and associated risk factors in Chinese patients on chronic HD.
  • To examine the relationship between HK prevalence at the facility level and patient mortality.
  • To assess the current management patterns of serum potassium (sK) and the utilization of potassium-binding drugs.

Main Methods:

  • The Visualize-HD study enrolled 50,983 patients from 231 HD centers in China.
  • Data collected included patient demographics, serum potassium levels, comorbidities, and mortality over three years.
  • Statistical analyses were performed to identify risk factors for HK and associations with mortality at both patient and facility levels.

Main Results:

  • The overall prevalence of HK (sK > 5.0 mmol/L) was 40.84%.
  • Three-year cumulative mortality was 21.3%, with 36.7% of deceased patients having HK at their final test.
  • Facilities with higher HK prevalence showed increased all-cause and cardiovascular mortality.
  • Hyperphosphatemia and increased use of potassium-binding drugs were associated with higher facility HK prevalence.

Conclusions:

  • Hyperkalemia is highly prevalent in Chinese HD centers and is linked to significant mortality risks.
  • HD centers with higher HK prevalence experience greater patient mortality.
  • Despite the importance of sK control, potassium-binding drugs appear to be underutilized, suggesting a need for improved management strategies.

Keywords:
Facility levelHemodialysisHyperkalemiaSerum potassium

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