The Model for End-stage Liver Disease score is potentially a useful predictor of hyperkalemia occurrence among hospitalized angiotensin receptor blocker users

Sheen, Seung Soo; Park, R. W.; Yoon, Dukyong; Shin, Gyu‐Tae; Kim, H.; Park, I.-W.

doi:10.1111/jcpt.12224

Cited by 4 publications

(2 citation statements)

References 50 publications

(69 reference statements)

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“…The physiopathologic association between the hyperkalemia and poor prognosis is complex and remains to be elucidated. The mechanisms that drive this poor prognosis are likely due to the occurrence of a severe disease and the use of therapeutic drugs, which in cases with a renal dysfunction may result in hyperkalemia [22]. This result is in line with our findings, indicating the positive relationship between serum potassium and creatinine as well as BUN, which are known markers of renal dysfunction.…”

Section: Discussionsupporting

confidence: 90%

Characteristics, Risk Factors, and Adverse Outcomes of Hyperkalemia in Acute-on-Chronic Liver Failure Patients

Cai

Wang

Jiang

et al. 2019

BioMed Research International

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Background. Hyperkalemia is a serious complication in cirrhotic patients. However, the clinical characteristics, risk factors, and its impact on the outcomes in acute-on-chronic liver failure (ACLF) patients remain unclear. Methods. We retrospectively recruited 650 ACLF patients in this study. The risk factors associated with hyperkalemia and its relationship with 90-day mortality were analyzed using multivariable regression models. Results. Among 650 patients with ACLF, 12.2% (79/650) had hyperkalemia during hospitalization. Higher admission serum potassium levels and the presence of acute kidney injury (AKI) were independent risk factors for hyperkalemia. The prevalence rates of hyperkalemia in patients with and without AKI were 23.6% and 4.6%, respectively (P<0.001). Hyperkalemia was a predictor of mortality in AKI and non-AKI patients. The 90-day mortality rates in non-AKI patients with and without hyperkalemia were 44.4% and 24.7%, respectively (P<0.001), and in AKI patients with and without hyperkalemia were 80.3% and 56.6%, respectively (P<0.001). Hepatic encephalopathy (HE), gastrointestinal bleeding, AKI, hyperkalemia, elevated total bilirubin (TBIL) and international normalized ratio (INR) values, and higher Model for End-Stage Liver Disease (MELD) and chronic liver failure-sequential organ failure assessment (CLIF-SOFA) scores were independent risk factors for predicting the 90-day mortality in ACLF patients. Conclusions. Hyperkalemia increases the 90-day mortality in ACLF patients; hyperkalemia is associated with AKI. Patients with both AKI and hyperkalemia had the worst outcome.

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Section: Discussionsupporting

confidence: 90%

Characteristics, Risk Factors, and Adverse Outcomes of Hyperkalemia in Acute-on-Chronic Liver Failure Patients

Cai

Wang

Jiang

et al. 2019

BioMed Research International

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“…A previous study showed that the Model for End-Stage Liver Disease (MELD) score, which is considered to be a marker of the severity of hepatic dysfunction, is a stronger predictor for angiotensin receptor blocker-related hyperkalemia than serum creatinine or eGFR alone, with MELD scores of ≥10 being associated with an increased risk of hyperkalemia [9].…”

Section: Discussionmentioning

confidence: 99%

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

Ahdoot

Hsiung

Agiro

et al. 2023

JCM

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Liver disease is often associated with dysfunctional potassium homeostasis but is not a well-established risk factor for hyperkalemia. This retrospective cohort study examined the potential relationship between liver disease and recurrent hyperkalemia. Patients with ≥1 serum potassium measurement between January 2004 and December 2018 who experienced hyperkalemia (serum potassium >5.0 mmol/L) were identified from the United States Veterans Affairs database. A competing risk regression model was used to analyze the relationship between patient characteristics and recurrent hyperkalemia. Of 1,493,539 patients with incident hyperkalemia, 71,790 (4.8%) had liver disease (one inpatient or two outpatient records) within 1 year before the index hyperkalemia event. Recurrent hyperkalemia within 1 year after the index event occurred in 234,807 patients (15.7%) overall, 19,518 (27.2%) with liver disease, and 215,289 (15.1%) without liver disease. The risk of recurrent hyperkalemia was significantly increased in patients with liver disease versus those without (subhazard ratio, 1.34; 95% confidence interval, 1.32–1.37; p < 0.0001). Aside from vasodilator therapy, the risk of recurrent hyperkalemia was not increased with concomitant medication. In this cohort study, liver disease was an independent risk factor strongly associated with recurrent hyperkalemia within 1 year, independent of concomitant renin–angiotensin–aldosterone system inhibitor or potassium-sparing diuretic use.

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Water, electrolyte, acid–base, and trace elements alterations in cirrhotic patients

Musso

Juarez²,

Glassock

2017

Int Urol Nephrol

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Chronic hepatic patients, and particularly those suffering from cirrhosis, are predisposed to different sort of water, electrolyte, acid-base, and trace elements disorders due to their altered liver function, and also to their exposition to infectious, inflammatory, oncologic, and pharmacologic variables whose combination undermines their homeostatic capability. Hyponatremia, hypokalemia, hyperkalemia, hypocalcemia, metabolic acidosis, respiratory, and metabolic alkalosis are the main internal milieu alterations in this group.

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The Model for End-stage Liver Disease score is potentially a useful predictor of hyperkalemia occurrence among hospitalized angiotensin receptor blocker users

Cited by 4 publications

References 50 publications

Characteristics, Risk Factors, and Adverse Outcomes of Hyperkalemia in Acute-on-Chronic Liver Failure Patients

Characteristics, Risk Factors, and Adverse Outcomes of Hyperkalemia in Acute-on-Chronic Liver Failure Patients

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

Water, electrolyte, acid–base, and trace elements alterations in cirrhotic patients

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