Impact of Hyperkalemia in Heart Failure and Reduced Ejection Fraction: A Retrospective Study

López‐López, Andrea; Franco‐Gutiérrez, Raúl; Pérez-Pérez, Alberto J.; Regueiro‐Abel, Margarita; Elices-Teja, Juliana; Abou-Jokh-Casas, C; González‐Juanatey, Carlos

doi:10.3390/jcm12103595

Cited by 2 publications

(1 citation statement)

References 53 publications

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“…In addition to being a marker of disease severity, hyperkalemia can directly affect cardiac function. Elevated serum potassium levels alter the resting membrane potential of cardiomyocytes, leading to impaired conduction velocity and decreased excitability [ 20 , 21 ]. This can result in arrhythmias, heart blocks, and reduced myocardial contractility [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Baseline Serum Potassium and 1-Year Readmission in Pediatric Patients with Heart Failure: A Retrospective Cohort Study

Han,

Huang,

et al. 2024

Children

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Pediatric heart failure (HF) is associated with high readmission rates, but the optimal serum potassium range for this population remains unclear. In this single-center retrospective cohort study, 180 pediatric patients hospitalized for HF between January 2016 and January 2022 were stratified into low-potassium (<3.7 mmol/L), middle-potassium (3.7–4.7 mmol/L), and high-potassium (≥4.7 mmol/L) groups based on the distribution of potassium levels in the study population. The primary outcome was readmission for HF within 1 year of discharge. Cox regression and restricted cubic spline models were used to assess the association between potassium levels and 1-year HF readmission rates. Notably, 38.9% of patients underwent 1 or more 1-year readmissions for HF within 1 year. The high-potassium group had a significantly higher readmission frequency than the middle-potassium group. In multivariate Cox regression models, potassium levels of ≥4.7 mmol/L were independently associated with increased 1-year readmission risk. A J-shaped relationship was observed between baseline potassium levels and 1-year readmission risk, with the lowest risk at 4.1 mmol/L. In pediatric patients with HF, a serum potassium level ≥ 4.7 mmol/L was independently associated with increased 1-year readmission risk. Maintaining potassium levels within a narrow range may improve outcomes in this population.

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Section: Discussionmentioning

confidence: 99%

Relationship between Baseline Serum Potassium and 1-Year Readmission in Pediatric Patients with Heart Failure: A Retrospective Cohort Study

Han,

Huang,

et al. 2024

Children

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Medical Costs and Economic Impact of Hyperkalemia in a Cohort of Heart Failure Patients with Reduced Ejection Fraction

López-López,

Regueiro-Abel,

Paredes-Galán

et al. 2024

JCM

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Background/Objectives: Hyperkalemia is a common electrolyte disorder in patients with heart failure and reduced ejection fraction (HFrEF). Renin-angiotensin-aldosterone system inhibitors (RAASi) have been shown to improve survival and decrease hospitalization rates, although they may increase the serum potassium levels. Hyperkalemia has significant clinical and economic implications, and is associated with increased healthcare resource utilization. The objective of the study was to analyze the management of hyperkalemia and the associated medical costs in a cohort of patients with HFrEF. Methods: An observational, longitudinal, retrospective, single-center retrospective study was conducted in patients with HFrEF who started follow-up in a heart failure unit between 2010 and 2021. Results: The study population consisted of 1181 patients followed-up on for 64.6 ± 38.8 months. During follow-up, 11,059 control visits were conducted, documenting 438 episodes of hyperkalemia in 262 patients (22.2%). Of the hyperkalemia episodes, 3.0% required assistance in the Emergency Department, 1.4% required hospitalization, and only 0.2% required admission to the Intensive Care Unit. No episode required renal replacement therapy. Reduction or withdrawal of RAASi was necessary in 69.9% of the hyperkalemia episodes. The total cost of the 438 hyperkalemia episodes was €89,178.82; the expense during the first year accounted for 48.8% of the total cost. Conclusions: Hyperkalemia is frequent in patients with HFrEF. It is often accompanied by a modification of treatment with RAASi. Hyperkalemia generates substantial costs in terms of healthcare resources and medical care, especially during the first year.

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Impact of Hyperkalemia in Heart Failure and Reduced Ejection Fraction: A Retrospective Study

Cited by 2 publications

References 53 publications

Relationship between Baseline Serum Potassium and 1-Year Readmission in Pediatric Patients with Heart Failure: A Retrospective Cohort Study

Relationship between Baseline Serum Potassium and 1-Year Readmission in Pediatric Patients with Heart Failure: A Retrospective Cohort Study

Medical Costs and Economic Impact of Hyperkalemia in a Cohort of Heart Failure Patients with Reduced Ejection Fraction

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