Prevalence of hyperkalemia among hemodialysis patients in Egypt.
BACKGROUND
Hyperkalemia is a frequent problem in patients with end stage renal disease (ESRD) on maintenance hemodialysis and is often attributed as a cause of deaths in these patients. The aim of this study was to estimate the prevalence of hyperkalemia among Egyptian hemodialysis patients.


METHODS
400 ESRD patients on maintenance hemodialysis were enrolled in the study. They were allowed their usual diets and medications during the study periods. For all patients, history and clinical examinations and serum potassium level was measured three times--pre- and post-1st session and pre-next session--at two successive sessions of hemodialysis.


RESULTS
The results of this study showed that the prevalence of hyperkalemia was 41.2%, 6.5%, and 66.9% of pre- and post-dialysis and before the next session of dialysis, respectively. Hyperkalemia significantly correlates with potassium-rich diets, non-compliant patients, two sessions of hemodialysis per week, and constipation in ESRD patients during the study periods. Serum potassium level was significantly higher in anuric ESRD patients than those who had residual renal function, patients using acetate dialysate than those using bicarbonate dialysate, and patients with low blood flow rate than those with higher blood flow rates. There was a non-significant correlation between serum potassium and ACEls, B-blockers, or diabetes.


CONCLUSIONS
Hyperkalemia is a frequent problem in patients with end stage renal disease in Egypt. Hyperkalemia significantly correlates with a potassium-rich diet and inadequate dialysis either by prescription or non-compliance. Thrice weekly bicarbonate dialysis with higher blood pump flow rate had better elimination of potassium.
Khedr
Essam
E
Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Abdelwhab
Saeed
S
El-Sharkawy
Magdy
M
El-Sharkay
Magdy
M
Ali
Medhat
M
El Said
Kadrey
K
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects; D003248:Constipation / Q000150:complications; D048909:Diabetes Complications / Q000453:epidemiology; D015314:Dialysis Solutions / Q000009:adverse effects; D004032:Diet / Q000009:adverse effects; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000453:epidemiology* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D015995:Prevalence; D014556:Urine; D055815:Young Adult
D000806:Angiotensin-Converting Enzyme Inhibitors; D015314:Dialysis Solutions; D011188:Potassium