How common is hyperkalaemia? A systematic review and meta-analysis of the prevalence and incidence of hyperkalaemia reported in observational studies

Humphrey, Toby J L; Davids, Mogamat Razeen; Chothia, Mogamat-Yazied; Pecoits‐Filho, Roberto; Pollock, Carol; James, Glen

doi:10.1093/ckj/sfab243

Cited by 41 publications

(32 citation statements)

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“…However, pulmonary oedema was described in a patient with kidney failure and hypertensive heart disease following 100 mL of 50% dextrose administered as a bolus [ 21 ]. Since hyperkalaemia frequently occurs in patients with kidney failure [ 1 ], decisions regarding the rate and volume of dextrose utilised should include the assessment of the patient’s volume and cardiac status.…”

Section: Discussionmentioning

confidence: 99%

“…Hyperkalaemia is a very common electrolyte disorder encountered in hospitalized patients [ 1 ] and, if left untreated, may result in life-threatening cardiac arrhythmias and death. The emergency treatment of hyperkalaemia includes shifting potassium into cells using intravenous insulin, with dextrose added before, with or after insulin administration to prevent hypoglycaemia.…”

Section: Introductionmentioning

confidence: 99%

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Hypoglycaemia due to insulin therapy for the management of hyperkalaemia in hospitalised adults: A scoping review

et al. 2022

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Introduction Hyperkalaemia is a very common electrolyte disorder encountered in hospitalised patients. Although hypoglycaemia is a frequent complication of insulin therapy, it is often under-appreciated. We conducted a scoping review of this important complication, and of other adverse effects, of the treatment of hyperkalaemia in hospitalised adults to map existing research on this topic and to identify any knowledge gaps. Materials and methods We followed the PRISMA-ScR guidelines. Studies were eligible for inclusion if they reported on any adverse effects in hospitalised patients ≥18-years-old, with hyperkalaemia receiving treatment that included insulin. All eligible research from 1980 to 12 October 2021 were included. We searched Medline (PubMed), Embase (Ovid), the Cochrane Library, CINHAL, Africa-Wide Information, Web of Science Core Collection, LILACS and Epistemonikos. The protocol was prospectively registered with the Open Science Framework (https://osf.io/x8cs9). Results Sixty-two articles were included. The prevalence of hypoglycaemia by any definition was 17.2% (95% CI 16.6–17.8%). The median timing of hypoglycaemia was 124 minutes after insulin administration (IQR 102–168 minutes). There were no differences in the prevalence of hypoglycaemia when comparing insulin dose (<10 units vs. ≥10 units), rate of insulin administration (continuous vs. bolus), type of insulin (regular vs. short-acting) or timing of insulin administration relative to dextrose. However, lower insulin doses were associated with a reduced prevalence of severe hypoglycaemia (3.5% vs. 5.9%, P = 0.02). There was no difference regarding prevalence of hypoglycaemia by dextrose dose (≤25 g vs. >25 g); however, prevalence was lower when dextrose was administered as a continuous infusion compared with bolus administration (3.3% vs. 19.5%, P = 0.02). The most common predictor of hypoglycaemia was the pre-treatment serum glucose concentration (n = 13 studies), which ranged from < 5.6–7.8 mmol/L. Conclusion This is the first comprehensive review of the adverse effects following insulin therapy for hyperkalaemia. Hypoglycaemia remains a common adverse effect in hospitalised adults. Future randomised trials should focus on identifying the optimal regimen of insulin therapy to mitigate the risk of hypoglycaemia.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hypoglycaemia due to insulin therapy for the management of hyperkalaemia in hospitalised adults: A scoping review

et al. 2022

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“…A recent systematic review reported a prevalence of 8·6% and an incidence rate of 5·1 cases per 100 person-years for hospitalised patients when hyperkalaemia was defined as a [K] of more than or equal to 5·5 mmol/L. 1 However, these frequencies included patients receiving kidney replacement therapy. No studies from the African continent reported on incidence, and only three reported on the prevalence of hyperkalaemia, 13 , 15 , 16 ([K] ≥ 5·5 mmol/L), which was high at 36·7%.…”

Section: Discussionmentioning

confidence: 99%

“…A recent, comprehensive systematic review reported an overall, global prevalence of 8·6% and an incidence of 5·1 cases per 100 person-years for hyperkalaemia, defined as a [K] ≥ 5·5 mmol/L, in hospitalised patients. 1 Few studies were identified from the African continent and none of the studies from Africa reported on the incidence of hyperkalaemia.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of hospitalised patients with hyperkalaemia at a South African tertiary healthcare centre

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“…Eskişehir Osmangazi Üniversitesi Tıp Fakültesi İç Hastalıkları, Romatoloji Bilim Dalı'nda Ocak 2010-Şubat 2020 yılları arasında SLE tanısı ile takip edilen hastalar SLE ICD kodu kullanılarak belirlendi. Hiperkalemi, potasyum düzeyi ≥5.5 mEq/L olarak kabul edildi (8). SLE için 1997 Amerikan Romatoloji Derneği (ACR) sınıflandırma kriterlerini (9)…”

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Evaluation of Causes of Hyperkalemia in Systemic Lupus Erythematosus Patients: Retrospective Single-Center Experience

MAMMADOVA

Korkmaz

2022

Osmangazi̇ Journal of Medicine

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Hyperkalemia is a major electrolyte disturbance with potentially life-threatening consequences. Varying prevalence and causes of hyperkalemia have been reported for study populations. Primary risk factors include renal insufficiency, diabetes mellitus (DM) and use of certain medication such as angiotensin converting enzyme (ACE) inhibitors. So far, causes of hyperkalemia in systemic lupus erythematosus (SLE) have not been investigated. Our aim here is to elaborate the causes underlying hyperkalemia and to determine the prevalence of hyperkalemic Type 4 renal tubular acidosis (RTA) in SLE patients. Among the patients followed up at the Department of Rheumatology due to SLE between January 2010 and February 2020, those with a potassium level of ≥5.5 mEq/L (hyperkalemia) were identified. For hyperkalemia patients, patient charts and digital record system were retrospectively searched for clinical and laboratory findings. Those with a non-SLE diagnosis and without hyperkalemia were excluded. Causes of hyperkalemia were classified as renal failure/insufficiency [acute kidney injury, chronic kidney disease (CKD)], medication, hormonal reasons (Addison’s disease, Type 4 RTA), pseudo-hemolysis, and others. Hyperkalemia was identified in 35 SLE patients, who were 40.1±16.9 years old, on average, and 85.7% of them were female. In 57.1% of the patients (n=20) lupus nephritis was identified. The most common type of renal involvement was Class IV lupus nephritis, at a rate of 68.7% (11/16). At the time of hyperkalemia diagnosis, mean duration of SLE disease was 5.2±5.52 years and mean SLE disease activation index (SLEDAI) was 19.8±13.4. Mean potassium level was 6.6 ±1.08 mEq/L. Metabolic acidosis was detected in 40% of the patients. The most common cause of hyperkalemia was renal failure/disease in 45.7% (n=16), followed by use of medication in 25.7%. In two (5%) patients hyperkalemia was attributed to Type 4 RTA. When patient subsets were compared by their causes of hyperkalemia for clinical and laboratory parameters, subset of renal failure/disease has a higher level of creatinine (p≤0.001), but there was no difference in other parameters. In line with its occurrence in general population, hyperkalemia in SLE most often occurs due to renal failure/disease. In addition, Type 4 RTA is an important reason for hyperkalemia. SLE patients presenting with hyperkalemia should also be queried for hyperkalemic Type 4 RTA, once the common causes for hyperkalemia are ruled out or in the event of persistent hyperkalemia.

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How common is hyperkalaemia? A systematic review and meta-analysis of the prevalence and incidence of hyperkalaemia reported in observational studies

Cited by 41 publications

References 15 publications

Hypoglycaemia due to insulin therapy for the management of hyperkalaemia in hospitalised adults: A scoping review

Hypoglycaemia due to insulin therapy for the management of hyperkalaemia in hospitalised adults: A scoping review

Outcomes of hospitalised patients with hyperkalaemia at a South African tertiary healthcare centre

Evaluation of Causes of Hyperkalemia in Systemic Lupus Erythematosus Patients: Retrospective Single-Center Experience

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