Incidence of Hyperkalemia in Patients Admitted to Emergency Services and Its Association with Clinical Outcomes in Chile: A Multicenter Clinical Study

Background: Hyperkalemia is a common electrolyte disturbance in patients admitted to emergency services, associated with an increased risk of cardiovascular events. This study aimed to evaluate the incidence of hyperkalemia and its association with mortality in emergency service patients in Chile. Methods: Multicenter observational clinical study. We evaluated patients over 18 years admitted to emergency services between 2022-2024. Admitting diagnoses, comorbidities, underlying medication use, and treatments received in the emergency department were assessed. One-year mortality rate was determined, stratified by kalemia levels. Multivariate analysis was performed to adjust for baseline variables. Results: 4,301 patients were evaluated, 2,308 had electrolyte measurements. Age: 56.5±11.0 years. Women: 47%. 159 (6.9%) had hyperkalemia (K > 5.5 mEq/L) and 44 (1.9%) had K > 6.0 mEq/L. Patients with hyperkalemia had a higher percentage of type 2 diabetes (33% vs 12%, p<0.01), chronic kidney disease (49% vs 5%, p<0.001), and greater use of renin-angiotensin-aldosterone inhibitors (68% vs 17%, p<0.001). 95% percent of patients with hyperkalemia > 6.0 mEq/L received pharmacological measures for potassium control, and 93% were hospitalized for evaluation and management. During follow-up, mortality in the overall group was 3.2%, with a higher mortality rate in the hyperkalemia group (6.1% versus 3.2%, p < 0.05). The presence of hyperkalemia had an adjusted hazard ratio of 2.1. See Figure 1. Conclusion: Our results show that, in Chilean patients admitted to emergency departments, the incidence of hyperkalemia is high and is an independent risk factor for mortality. These data indicate the importance of screening for hyperkalemia and the need for effective and safe therapies.