TY - JOUR T1 - Epidemiology of hyperkalemia in chronic kidney disease JO - Nefrología (English Edition) T2 - AU - Belmar Vega,Lara AU - Galabia,Emilio Rodrigo AU - Bada da Silva,Jairo AU - Bentanachs González,Marta AU - Fernández Fresnedo,Gema AU - Piñera Haces,Celestino AU - Palomar Fontanet,Rosa AU - Ruiz San Millán,Juan Carlos AU - de Francisco,Ángel Luis Martín SN - 20132514 M3 - 10.1016/j.nefroe.2018.11.014 DO - 10.1016/j.nefroe.2018.11.014 UR - https://www.revistanefrologia.com/en-epidemiology-hyperkalemia-in-chronic-kidney-articulo-S2013251419300896 AB - BackgroundHyperkalaemia is a significant electrolyte imbalance in chronic kidney disease (CKD). Renin–angiotensin–aldosterone system inhibitors (RAASi) have beneficial cardio-renal properties, although they can often cause hyperkalaemia. ObjectiveTo examine the prevalence of hyperkalaemia in CKD, identify factors associated with its appearance and the relationship between hyperkalaemia and mortality. Patients and methodsRetrospective observational study on patients with CKD in the period 1971–2017. The population was categorised into 3 groups: Group 1, patients with CKD without renal replacement therapy; Group 2, patients on haemodialysis; and Group 3, patients on continuous ambulatory peritoneal dialysis. ResultsA total of 2629 patients were evaluated. The prevalence observed in the different groups was: 9.6%, 16.4% and 10.6%, respectively. Risk factors related to the appearance of hyperkalaemia in the CKD group were glomerular filtration rate (GFR) (p<0.001), plasma creatinine (p<0.001), plasma sodium (p<0.001), haemoglobin (p=0.028), diastolic blood pressure (p=0.012), intake of ACE inhibitors and/or angiotensin ii receptor blockers (p=0.008), treatment with metformin (p<0.001) and diabetes (p=0.045). Treatment with RAASi significantly increased hyperkalaemia as GFR decreased, as well as in patients with diabetes or heart failure. ConclusionsHyperkalaemia is a frequent metabolic alteration in CKD patients that increases in the presence of drugs with beneficial cardio-renal properties (RAASi), which means that patients often lose the benefit associated with these drugs. New, recently appearing non-absorbable compounds, which bind to potassium in the gastrointestinal tract, enhancing faecal excretion and thus maintaining the cardio-renal benefit of the RAASi, could be relevant in the progress of patients with CKD. ER -