A determination of the current causes of hyperkalaemia and whether they have changed over the past 25 years. Issue 4 (August 2014)

• Record Type: Journal Article
• Authors: Muschart, X.; Boulouffe, C.; Jamart, J.; Nougon, G.; Gérard, V.; de Cannière, L.; Vanpee, D.
• Is Part Of: Acta clinica belgica. Volume 69:Issue 4(2014)
• Page Start: 280
• Page End: 284
• Publication Date: 2014-08
• Subjects: Clinical medicine -- Periodicals; Diagnosis, Laboratory -- Periodicals; 616.005
• DOI: 10.1179/0001551214Z.00000000077
• Languages: English
• ISSNs: 1784-3286

Abstract

<abstract> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec> <title>Objective:</title> <p>Hyperkalaemia is a potentially lethal electrolyte disorder. The objective of this study was to determine if the causes of hyperkalaemia-related visits to the emergency department (ED) have changed since 25 years.</p> </sec> <sec> <title>Methods:</title> <p>All patients presenting to the ED with hyperkalaemia between January 2009 and August 2011 were included in this retrospective, single-centre study. Patients were divided into one of these three categories: mild (5·2⩽K<sup>+</sup><5·8 mEq/l), moderate (5·8⩽K<sup>+</sup><7·0 mEq/l) or severe hyperkalaemia (K<sup>+</sup>⩾7·0 mEq/l). The causes of hyperkalaemia were divided into three groups: renal failure (RF), potassium-increasing drugs (PIDs) or others.</p> </sec> <sec> <title>Results:</title> <p>Overall, 139 patients with hyperkalaemia were included in the study (mean K<sup>+</sup> of 6·2 mEq/l): 35% with mild, 49% with moderate and 16% with severe hyperkalaemia. Eighty-three per cent of patients (<italic>n</italic> = 115) had RF with creatinine levels ⩾1·25 mg/dl or estimated glomerular filtration rate (eGFR) levels ⩽60 ml/min/1·73 m<sup>2</sup>. Serum potassium levels were significantly related with creatinine and eGFR values (<italic>P</italic><0·001). The severity of hyperkalaemia was significantly related with creatinine levels ⩾1·25 mg/dl (<italic>P</italic> = 0·002) and eGFR values ⩽60 ml/min/1·73 m<sup>2</sup> (<italic>P</italic> = 0·005). Seventy-five per cent of patients (<italic>n</italic> = 105) were taking PIDs. Potassium levels were significantly related with PIDs (<italic>P</italic><0·001), in particularly spironolactone (<italic>P</italic> = 0·001) and angiotensin-converting enzyme inhibitors (<italic>P</italic> = 0·008). The category 'others' included 7% of patients (<italic>n</italic> = 10).</p> </sec> <sec> <title>Conclusions:</title> <p>RF (83%) and PIDs (75%) remain common causes of hyperkalaemia. Hyperkalaemia is significantly related with four variables: creatinine levels, spironolactone, ACEIs and beta-blocker intake. The causes of hyperkalaemia have not changed in recent years.</p> </sec> </abstract>