Hyperkalemia and CKD

Background: Hyperkalemia (HK) is a frequent complication of chronic kidney disease (CKD), with a prevalence of between 14-20%, which is associated with different factors, such as the use of some antihypertensives (ARA's, IECAS), age, gender, Diabetes Mellitus (DM), cancer. Our aim was to determine the prevalence and factors associated with HK in patients with CKD. Methods: Transversal study. Patients with CKD who attended the nephrology service of the Hospital General de México during the period Feb 2019 to August 2022 were included. The prevalence and factors associated with HK (K>5) by CKD stage were estimated using regression logistics (95% CI). Results: 1249 patients were included, with an average age of 55±16 years; 52% of the population female. The prevalence of HK was 26% (321). The standardized B coefficient for the relationship between serum levels and GFR was -0.334, (p<0.0001). Figure 1 shows the prevalence of HK by severity grade across CKD stages. The factors associated with HK are presented in Figure 2. Conclusion: An association between HK and the use of commonly prescribed medications, such as oral hypoglycemics and loop diuretics, was identified from the early stages of CKD, along with the presence of diabetes mellitus. It is necessary to intentionally screen for HK from the early stages of CKD and to implement pharmacological treatment with the aim of reducing the risk of CKD progression, death, and cardiovascular events.Figure 1. Prevalence of HK by severity grade across CKD stagesFigure 2. Factors associated with HK