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Hyperkalaemia on admission tied to higher mortality in heart failure

02 Oct 2017

Serum potassium concentrations greater than 5.5 mEq/L at admission is independently correlated with elevated short- and long-term mortality in heart failure (HF) patients, a recent study suggests.

The study included 4,031 heart failure patients, 83 percent (n=3,349) of whom had low-normal potassium levels at admission, 11 percent (n=461) had borderline-high levels and 6 percent (n=221) had hyperkalaemia. Patients without serum potassium measurements at admission were excluded.

Hyperkalaemia patients had significantly higher unadjusted 30-day mortality rates compared with low-normal potassium patients (13 vs 7 percent; p=0.002). However, after adjusting for comorbidities, gender and age, the significant relationship was attenuated (hazard ratio [HR], 1.57; 95 percent CI, 0.73 to 3.35).

According to Kaplan-Meier survival analysis, hyperkalaemia and borderline-high potassium patients had significantly higher rates of 1-year all-cause mortality than those with low-normal potassium (40 vs 34 vs 27 percent, respectively; log rank p<0.01).

Adjusting for comorbidities, age and gender showed that only hyperkalaemia remained significantly related to 1-year mortality risk (HR, 1.51; 1.04 to 2.2), while borderline-high potassium levels did not (HR, 0.79; 0.57 to 1.09).

Ten-year all-cause mortality rates were also significantly higher in patients with hyperkalaemia and borderline-high potassium levels than in those with low-normal potassium levels (92 vs 88 vs 82 percent, respectively; log rank p<0.001). The difference between hyperkalaemia and borderline-high potassium level patients also reached significance (p=0.016).

Similarly, multivariate analysis adjusted for age, gender and comorbidities found that only hyperkalaemia was associated with higher all-cause mortality (HR, 1.31; 1.035 to 1.66; p=0.025), while borderline-high potassium was not (HR, 0.985; 0.83 to 1.16; p=0.86).

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Most Read Articles
Roshini Claire Anthony, 4 days ago

The combined use of piperacillin and tazobactam does not appear to be a suitable alternative to meropenem for patients with bloodstream infections caused by ceftriaxone-resistant Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae), according to results of the MERINO* trial.

Tristan Manalac, 19 May 2018
Taking oral antibiotics appears to increase the risk of nephrolithiasis, according to a recent study. Moreover, the risk seems to be compounded for individuals with recent antibiotic exposure and those who were exposed at a younger age.
2 days ago
Patients with inflammatory bowel disease are at increased risk of developing acute myocardial infarction (AMI) or heart failure, although the prevalence of traditional risk factors for such cardiovascular disorders appears to be low, as reported in a recent study.
3 days ago
Early renin-angiotensin-aldosterone system (RAAS) blockade with renin-angiotensin system inhibitors (RASI) leads to better short- and long-term renal outcomes in systemic lupus erythematosus (SLE) patients with antiphospholipid-associated nephropathy (aPLN), according to a study, adding that this renal protective effect is independent of RASI’s antihypertensive and antiproteinuric effects.