Yu Yalin, Vangaveti Venkat N, Schnetler Rudolf J, Crowley Benjamin J, Mallett Andrew J
Department of Internal Medicine, Townsville University Hospital, Douglas, QLD, Australia.
Townsville Institute of Health Research and Innovation, Townsville University Hospital, Douglas, QLD, Australia.
BMC Nephrol. 2024 Dec 18;25(1):454. doi: 10.1186/s12882-024-03863-w.
Hyperkalaemia is one of the common electrolyte disorders among hospital patients, affected by many risk factors including medications and medical conditions. Prompt treatment is important given its impact on patient mortality and morbidity, which can lead to negative patient outcomes and healthcare resource utilisation. This study aims to describe the prevalence, characteristics, and treatment of patients admitted to hospitals with hyperkalaemia and compare findings between patients with kidney failure on maintenance haemodialysis therapy and patients without kidney failure. It also aims to identify associations between hyperkalaemia and hospital length of stay.
We undertook a retrospective cohort study on adult patients admitted to Townsville University Hospital between 1st January 2018 and 31st December 2022 (n = 99,047). Patients were included if they had a serum potassium result of 5.1 mmol/L and above during their admission/s. Statistical analysis was conducted using several methods. A Welch's t test and Chi-square test were employed to assess differences between groups of patients with kidney failure on maintenance haemodialysis therapy and those without kidney failure. For comparison among multiple groups with varying severities of hyperkalaemia, the Kruskal-Wallis test with Mann-Whitney U test and logistic regression were used.
8,775 hyperkalaemic patients were included in the study, with a mean age of 64.7 years. The prevalence of hyperkalaemia was 8.9% of patients. Risk factors for hyperkalaemia were highly prevalent among those who had the condition during their admissions. Patients with kidney failure on haemodialysis who had hyperkalaemia were, on average, 6 years younger, more often Indigenous, and experienced more severe hyperkalaemia compared to other patients without kidney failure. There was a notable difference in hyperkalaemia treatment between groups with varying degrees of hyperkalaemia severity. Hyperkalaemia was not found to be associated with prolonged hospital stay.
Hyperkalaemia is common among hospital admissions. Patients with kidney failure on haemodialysis are at higher risk of developing severe hyperkalaemia. Treatment for hyperkalaemia was variable and likely insufficient. Timely detection and treatment of hyperkalaemia is recommended.
高钾血症是住院患者常见的电解质紊乱之一，受多种危险因素影响，包括药物和疾病状况。鉴于其对患者死亡率和发病率的影响，及时治疗很重要，这可能导致患者出现不良后果并影响医疗资源的利用。本研究旨在描述高钾血症住院患者的患病率、特征和治疗情况，并比较维持性血液透析治疗的肾衰竭患者和非肾衰竭患者的研究结果。它还旨在确定高钾血症与住院时间之间的关联。
我们对2018年1月1日至2022年12月31日期间入住汤斯维尔大学医院的成年患者进行了一项回顾性队列研究（n = 99,047）。如果患者在住院期间血清钾结果为5.1 mmol/L及以上，则纳入研究。使用多种方法进行统计分析。采用韦尔奇t检验和卡方检验评估维持性血液透析治疗的肾衰竭患者组与非肾衰竭患者组之间的差异。对于高钾血症严重程度不同的多组患者进行比较时，使用了带有曼-惠特尼U检验的克鲁斯卡尔-沃利斯检验和逻辑回归。
8775例高钾血症患者纳入研究，平均年龄64.7岁。高钾血症的患病率为患者的8.9%。高钾血症的危险因素在住院期间患有该疾病的患者中非常普遍。与其他非肾衰竭患者相比，患有高钾血症的血液透析肾衰竭患者平均年轻6岁，更多为原住民，且高钾血症更为严重。不同程度高钾血症严重程度组之间的高钾血症治疗存在显著差异。未发现高钾血症与住院时间延长有关。
高钾血症在住院患者中很常见。接受血液透析的肾衰竭患者发生严重高钾血症的风险更高。高钾血症的治疗方法不一，可能并不充分。建议及时检测和治疗高钾血症。
