Prevalence and economic burden of hyperkalemia in the United States Medicare population

Abstract

Objective: To estimate the prevalence and economic burden of hyperkalemia in the United States (US) Medicare population. Methods: Patients were selected from a 5% random sample of Medicare beneficiaries (01 January 2010-31 December 2014) to estimate the prevalence and economic burden of hyperkalemia. The prevalence for each calendar year was calculated as the number of patients with hyperkalemia divided by the total number of eligible patients per year. To estimate the economic burden of hyperkalemia, patients with hyperkalemia (cases) were matched 1:1 to patients without hyperkalemia (controls) on age group, chronic kidney disease [CKD] stage, dialysis treatment, and heart failure. The incremental 30-day and 1-year resource utilization and costs (2016 USD) associated with hyperkalemia were estimated. Results: The estimated prevalence of hyperkalemia was 2.6-2.7% in the overall population and 8.9-9.3% among patients with CKD and/or heart failure. Patients with hyperkalemia had higher 1-year rates of inpatient admissions (1.28 vs. 0.44), outpatient visits (30.48 vs. 23.88), emergency department visits (2.01 vs. 1.17), and skilled nursing facility admissions (0.36 vs. 0.11) than the matched controls (all p < .001

Inpatient management and post-discharge outcomes of hyperkalemia

“…Hyperkalemia recurrence also increased with severity (mild: 13.3%, moderate: 15.4%, severe: 18.4% within 30 days). The post-discharge outcomes reported in this study are comparable to a retrospective cohort study that assessed the burden associated with hyperkalemia readmissions 30, 60, and 90 days post-discharge [21]. In that study, hyperkalemia-related hospitalizations were associated with significantly more readmissions than hospitalizations unrelated to hyperkalemia (30 days: 12.5% vs. 8.4%; 60 days: 18.3% vs. 12.7%; 90 days: 24.3% vs. 16.8%; all p < 0.001) [21].…”

“…Despite the frequent occurrence of hyperkalemia in hospitalized patients, scant recent real-world evidence is available regarding patient outcomes following hospitalization [15,[18][19][20]. A recent study found that patients with hyperkalemia-related hospitalizations have significant post-discharge economic and readmission burdens [21,22]. However, evidence that comprehensively and longitudinally describes both the inpatient management and post-discharge outcomes by hyperkalemia severity is needed.…”

Hyperkalaemia in Heart Failure

“…Mu et al analysed a 5% random sample of Medicare beneficiaries in the US between 2010 and 2014 and randomised them based on the presence of hyperkalaemia (potassium level >5 mEq/l). [ 58 ] Those with hyperkalaemia had more inpatient admissions, outpatient and emergency department visits and skilled nursing care facility admissions. Patients with hyperkalaemia and concomitant HF and/or CKD had even higher rates of hospital visits and longer inpatient stays.…”

Healthcare utilization and expenditures associated with hyperkalemia management: a retrospective study of Medicare Advantage patients

“…While there are several published observational studies comparing HRU and healthcare expenditures for patients with and without HK 2,[12][13][14][15] , research regarding the relative effect of different treatment modalities among patients with HK are emerging 14,[19][20][21][22][23][24][25] . Among Medicare Advantage patients with HK in real-world clinical practice, this study aimed to evaluate the outcomes for patients exposed to patiromer compared to patients not exposed to a K + binder.…”

“…In the United States (US), the prevalence of HK was reported to be 1-2% overall, and potentially as high as 15% among Medicare patients with CKD and/or CHF 11,12 . HK has been reported to be associated with increased healthcare costs and healthcare resource utilization (HRU; eg, inpatient admission and emergency department [ED] encounters) [13][14][15] . In studies using administrative claims data in the US, researchers found that patients with HK incurred 58% higher total healthcare expenditures and were 40% more likely to be readmitted, compared to patients without HK 12,15 .…”