Outcomes in Older Inpatients with Hyperkalemia: A Follow-up Observational Study

Abstract

Objectives: Hyperkalemia is a common electrolyte disturbance encountered in hospitalized older patients secondary to age-related physiological changes in the kidneys, multiple comorbidities, and the burden of multiple medication usage. Metabolic acidosis, rhabdomyolysis, and tumor lysis syndrome cause the shift of potassium into the extracellular space. This contributes to hyperkalemia. This study aims to determine the outcomes in patients with hyperkalemia admitted to a tertiary care center and to list the factors contributing to the development of hyperkalemia in these patients. Methods: This was a prospective observational study conducted among older inpatients (≥60 years of age) admitted to the geriatric and medical wards in a tertiary care hospital. The patients with hyperkalemia were followed up till discharge or death. Results: Among the 225 study participants who presented with hyperkalemia, the mortality rate was found to be 22.2%. In the multivariate analysis, older people aged more than 70 years (P = 0.007) and those who were male had a significantly higher mortality (P = 0.009). The use of angiotensin-converting enzyme inhibitors (ACEIs) (P = 0.049) and beta-blockers (P = 0.02) was significantly associated with the development of hyperkalemia. Conclusions: ACEIs and beta-blockers increased the risk of developing hyperkalemia in the study population. Hyperkalemia was found to be associated with an increase in mortality, especially in the very old (>70 years) and in males.

Keywords

• angiotensin-converting enzyme inhibitors
• beta-blockers
• hyperkalemia
• older people