From: Severe hyperkalemia requiring hospitalization: predictors of mortality
Characteristics | Number (percentage) unless indicated otherwise |
---|---|
Age, yearsa | 61.1 ± 15.0 |
Male gender | 586 (63.5) |
Serum potassium level, mEq/L (K+ ≥6.5 mEq/L)a | 7.1 ± 0.7 |
Serum potassium level at admission, mEq/La | 5.7 ± 1.5 |
The type of admission | |
Planned admission | 290 (31.4) |
Emergent admission | 633 (68.6) |
Admission for severe hyperkalemia | 93 (10.1) |
Onset of hyperkalemia | |
At the time of admission to the hospital | 339 (40.0) |
During the period of hospitalization | 554 (60.0) |
Period from admission to diagnosis, daysa | 16.7 ± 34.3 |
Location at diagnosis with hyperkalemia | |
Intensive care unit | 171 (30.9) |
Surgical ward | 111 (20.0) |
Medical ward | 244 (44.0) |
Emergency room | 28 (5.1) |
Multi-organ failure at admission | 108 (11.7) |
Multi-organ failure at the time of diagnosis | 226 (24.5) |
Diagnosis at the time of cardiac arrest | 187 (20.3) |
Symptoms pertinent to hyperkalemia | 432 (46.8) |
Cardiac arrest | 187 (43.3) |
Arrhythmia | 152 (35.2) |
Other typical symptoms | 93 (21.5) |
Underlying diseases | |
Diabetes mellitus | 375 (40.6) |
Hypertension | 427 (46.3) |
Chronic kidney disease (CKD) | 648 (70.2) |
Unknown stage | 10 (1.5) |
Stage II | 158 (24.4) |
Stage III | 207 (31.9) |
Stage IV | 79 (12.3) |
Stage V | 194 (29.9) |
ESRD on dialysis | 160 (17.3) |
Malignancy | 299 (32.4) |
Liver cirrhosis | 161 (17.4) |
Coronary artery disease | 108 (11.7) |
Pulmonary diseases | 95 (10.3) |
Cerebrovascular disease | 95 (10.3) |
History of recurrence for severe hyperkalemia | 62 (6.7) |
Congestive heart failure | 71 (7.7) |
Arrhythmia | |
Atrial fibrillation | 100 (10.8) |
First degree atrioventricular block | 27 (2.9) |
Thyroid disease | 38 (4.1) |
Drugs | |
Angiotensin-converting enzyme inhibitor | 60 (6.5) |
Angiotensin II receptor blocker | 165 (17.9) |
Potassium-sparing diuretics | 108 (11.7) |
Beta blocker | 124 (13.4) |
NSAIDs | 22 (2.4) |
Digoxin | 25 (2.7) |
Potassium supplements | 129 (14.0) |
Coexisting medical conditions | |
1. Renal impairment | |
New-onset acute kidney injury (AKI) | 205 (22.2) |
AKI superimposed on CKD | 478 (51.8) |
Infection | 304 (32.9) |
Volume depletion | 426 (46.2) |
Bleeding | 173 (18.7) |
2. Potassium shift from ICF to ECF | |
Metabolic acidosis | 592 (64.1) |
Rhabdomyolysis | 52 (5.6) |
Tumor lysis syndrome | 11 (1.2) |
3. Others | |
Poor compliance to K+-lowering agents | 30 (3.3) |
Constipation | 7 (0.8) |
Transfusion | 24 (2.6) |
Adrenal insufficiency | 16 (1.7) |
ECG changes pertinent to hyperkalemia | 481/673 (71.5) |
Period from diagnosis to ECG change, minutesa | 21.6 ± 99.0 |
Typical findings | 339 (70.5) |
Atypical findings | 142 (29.5) |