MO879: Prevalence, Recurrence and Seasonal Variation of Hyperkalaemia in Patients Receiving Thrice-Weekly Haemodialysis. (3rd May 2022)

• Record Type: Journal Article
• Authors: Tsiagka, Dimitra; Georgianos, Panagiotis; Pikilidou, Maria; Vaios, Vasilios; Minasidis, Elias; Karpetas, Antonios; Roumeliotis, Stefanos; Metallidis, Simeon; Liakopoulos, Vassilios; Zebekakis, Pantelis
• Is Part Of: Nephrology dialysis transplantation. Volume 37(2022)Supplement 3
• Publication Date: 2022-05-03
• Subjects: Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfac083.061
• Languages: English
• ISSNs: 0931-0509

Abstract

Abstract: BACKGROUND AND AIMS: Prospective cohort studies have shown that among patients on haemodialysis, hyperkalaemia is strongly associated with excess risk for cardiovascular-related hospitalizations and sudden cardiac death [1 –4 ]. However, the actual burden of hyperkalaemia, the rates of its recurrence and seasonality in its variation still remain unclear. METHOD: Between June 2020 and May 2021, 1786 mid-week predialysis serum potassium (sK) measurements were retrospectively recorded from 149 patients receiving thrice-weekly haemodialysis in a single-centre in Thessaloniki, Greece. The prevalence, recurrence and seasonal variation of hyperkalaemia were assessed using three prespecified sK thresholds (≥5.1, ≥5.5 and ≥ 6.0 mmol/L). RESULTS: At baseline (June 2020), 60.4%, 42.2% and 13.4% of patients had sK levels ≥ 5.1, ≥5.5 and ≥ 6.0 mmol/L, respectively. At any time-point during the 1-year-long follow-up, 85.2%, 69.8% and 38.9% of patients experienced at least 1 hyperkalaemic episode at the sK threshold of ≥ 5.1, ≥5.5 and ≥ 6.0 mmol/L, respectively. Of the 104 patients experiencing an initial sK elevation ≥ 5.5 mmol/L, hyperkalaemia at the same threshold reoccurred in 60.6% at month-1, in 47.1% at month-2 and in 46.1% at month-3 of follow-up. Seasonal variation was also observed, with the prevalence of hyperkalaemia to be significantly higher in summer. In multivariate logistic regression analysis, shorter delivered haemodialysis < 4 h/session {odds ratio (OR): 2.568; [95% confidence interval (95% CI): 1.045–6.313]} and the use of a high versus a low K concentration in the dialysate (OR: 14.646; 95% CI: 2.727–78.647) were the two factors that were associated with a significantly higher odds of hyperkalaemia at any time-point of the follow-up period. CONCLUSION: The present study shows that among patients receiving conventional thrice-weekly haemodialysis, the rates of hyperkalaemia prevalence and recurrence are very high, reflecting the large unmet need to identify more effective potassium-lowering therapeutic interventions in this high-risk population.