Biochemical Risk Factors Associated With Hyperkalemia in Cirrhotic Patients

Abstract

Introduction: Patients with cirrhosis suffer from fluid and electrolyte imbalance. The usually reported electrolyte disorders include hyperkalemia, hyponatremia, and hypokalemia. The regional data about the prevalence and risk factors associated with hyperkalemia in cirrhotic patients are not sufficient enough. The purpose of this study is to determine various risk factors associated with hyperkalemia, which will assist in the early detection of cirrhotic patients at risk of hyperkalemia. Methods: This cross-sectional study was conducted in the internal medicine and gastroenterology departments of a tertiary care hospital in Pakistan from March 2021 to June 2021. Sonographically documented liver cirrhosis patients (n=500), of either gender and between the ages of 18 and 70 years, were enrolled in the study. After enrollment, patients' demographics were noted in a self-structured questionnaire. Participant's Child-Pugh score was also noted in the questionnaire. After a detailed history, 5 mL of venous blood was drawn in two vials via phlebotomy and send to the laboratory to measure serum potassium, creatinine, albumin, and bilirubin levels.Result: Out of the total 500 participants, 101 (20.2%) participants had hyperkalemia. It was significantly more prevalent in participants with Child-Pugh C class and in those with a serum creatinine of more than 1.3 mg/dL. Similarly, it was more prevalent in participants with albumin levels less than 2.5 mg/dL. Conclusion:Hyperkalemia is associated with Child-Pugh class C. It has a direct relationship with serum creatinine levels which is an indicator of renal function, and an inverse relationship with serum albumin levels, an indicator of hepatic synthetic function.

Liver Disease Is a Risk Factor for Recurrent Hyperkalemia: A Retrospective Cohort Study

“…In patients with acute-on-chronic liver disease, hyperkalemia often develops secondary to reduced kidney function, resulting in impaired urinary K + excretion and increased renal sodium and water absorption [3,7]. Hyperkalemia may also be caused by the use of K + -sparing diuretics, such as spironolactone or eplerenone [10], which are recommended as first-line treatment in patients with cirrhosis and grade 2 ascites, either alone or in conjunction with a loop diuretic [11]. However, in this analysis, patients with chronic liver disease were at increased risk of hyperkalemia recurrence regardless of concomitant K + -sparing diuretic use.…”