title: Hyperkalemia among hospitalized patients and association between duration of hyperkalemia and outcomes.
abstract: BACKGROUND
  The aim of the study was to investigate predictors of mortality in patients hospitalized with hyperkalemia.
  
  
  METHODS
  Data among hospitalized patients with hyperkalemia (serum potassium ≥ 5.1 mEq/l) were collected. Patients with end-stage renal disease on dialysis were excluded.
  
  
  RESULTS
  Of 15,608 hospitalizations, 451 (2.9%) episodes of hyperkalemia occurred in 408 patients. In patients with hyperkalemia, chronic kidney disease, hypertension, diabetes, coronary artery disease and heart failure were common comorbidities. Acute kidney injury (AKI) and metabolic acidosis were common metabolic abnormalities, and 359 patients (88%) were on at least one drug associated with hyperkalemia. Mean duration to resolution of hyperkalemia was 12 ±9.9 h. Nonsteroidal anti-inflammatory drugs (HR = 1.59), highest potassium level (HR = 0.61), tissue necrosis (HR = 0.61), metabolic acidosis (HR = 0.77), and AKI (HR = 0.77) were significant independent determinants of duration prior to hyperkalemia resolution. Tissue necrosis (OR = 4.55), potassium supplementation (OR = 5.46), metabolic acidosis (OR = 4.84), use of calcium gluconate for treatment of hyperkalemia (OR = 4.62), AKI (OR = 3.89), and prolonged duration of hyperkalemia (OR = 1.06) were significant independent predictors of in-hospital mortality.
  
  
  CONCLUSIONS
  Tissue necrosis, potassium supplementation, metabolic acidosis, calcium gluconate for treatment of hyperkalemia, AKI and prolonged duration of hyperkalemia are independent predictors of in-hospital mortality.
authors.affiliation: Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
authors.forename: Jagadish
authors.initials: J
authors.lastname: Khanagavi
authors.affiliation: Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
authors.forename: Tanush
authors.initials: T
authors.lastname: Gupta
authors.affiliation: Division of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
authors.affiliation: Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
authors.forename: Tushar
authors.initials: T
authors.lastname: Shah
authors.affiliation: Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
authors.forename: Jalaj
authors.initials: J
authors.lastname: Garg
authors.affiliation: Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Chul
authors.initials: C
authors.lastname: Ahn
authors.affiliation: Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
authors.forename: Sachin
authors.initials: S
authors.lastname: Sule
authors.affiliation: Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Peterson
keywords: drug-induced hyperkalemia; in-hospital mortality; potassium supplements; prolonged hyperkalemia