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Table 6 Factors associated with hyperkalemia recurrence and other adverse clinical outcomes following an index hyperkalemic event

From: Epidemiology and health outcomes associated with hyperkalemia in a primary care setting in England

 

Stepwise-adjusted odds ratio (95% CI)

HK recurrence

Cardiac arrhythmia

All-cause hospitalization

Death

Age range, years

 18–29

REF

REF

REF

REF

 30–39

1.30 (1.13–1.48)

1.08 (0.58–2.02)

0.96 (0.90–1.02)

1.58 (0.92–2.71)

 40–49

1.85 (1.64–2.08)

1.52 (0.88–2.62)

0.90 (0.85–0.95)

3.14 (1.95–5.08)

 50–59

2.29 (2.04–2.58)

2.94 (1.74–4.96)

0.98 (0.93–1.04)

6.19 (3.87–9.90)

 60–69

2.73 (2.43–3.07)

6.83 (4.08–11.43)

1.15 (1.09–1.22)

13.36 (8.39–21.27)

 70–79

3.23 (2.87–3.64)

15.52 (9.28–25.96)

1.42 (1.34–1.50)

30.23 (19.00–48.11)

  ≥ 80

3.45 (3.06–3.89)

33.18 (19.82–55.56)

1.77 (1.67–1.88)

91.03 (57.21–144.86)

Sex

 Male

REF

REF

REF

REF

 Female

0.70 (0.65–0.75)

0.87 (0.83–0.90)

Baseline laboratory values

 BUN

1.50 (1.37–1.64)

 eGFR

0.99 (0.99–0.99)

1.00 (1.00–1.00)

1.00 (1.00–1.00)

1.00 (1.00–1.00)

Smoking status

 Current

1.12 (1.08–1.15)

1.22 (1.10–1.34)

1.18 (1.15–1.21)

1.86 (1.76–1.96)

 Former

1.07 (1.04–1.10)

1.04 (0.97–1.11)

1.09 (1.06–1.11)

1.07 (1.02–1.11)

 Never

REF

REF

REF

REF

 Unknown

1.04 (0.84–1.28)

1.29 (0.79–2.12)

0.99 (0.85–1.16)

1.91 (1.53–2.37)

Comorbidity

 Hypertension

1.23 (1.19–1.27)

1.11 (1.03–1.19)

 Hyperlipidemia

1.04 (1.01–1.07)

0.86 (0.80–0.93)

0.79 (0.76–0.83)

 Ischemic heart disease

1.15 (1.11–1.18)

1.42 (1.31–1.54)

1.28 (1.25–1.31)

1.12 (1.07–1.17)

 Arrhythmia (including atrial fibrillation)

1.10 (1.06–1.14)

1.30 (1.27–1.34)

1.33 (1.27–1.39)

 Heart failure

1.10 (1.03–1.17)

1.32 (1.12–1.56)

1.14 (1.08–1.20)

1.38 (1.29–1.48)

 Cerebrovascular disease

1.04 (1.00–1.08)

1.27 (1.16–1.40)

1.18 (1.14–1.22)

1.60 (1.53–1.68)

 Peripheral artery disease

1.10 (1.03–1.17)

1.29 (1.11–1.50)

1.31 (1.25–1.38)

1.43 (1.32–1.54)

 Diabetes (types 1 and 2)

1.86 (1.81–1.91)

1.08 (1.05–1.11)

1.27 (1.21–1.33)

 Chronic kidney disease

1.19 (1.15–1.23)

1.08 (1.05–1.11)

1.09 (1.05–1.15)

 Obstructive lung disease

1.06 (1.03–1.09)

1.36 (1.26–1.46)

1.28 (1.25–1.31)

1.36 (1.31–1.42)

 Liver disease

1.21 (1.15–1.28)

1.47 (1.26–1.72)

1.50 (1.44–1.56)

2.01 (1.87–2.17)

Concomitant medication

 ACE inhibitor

1.27 (1.23–1.31)

0.90 (0.88–0.92)

0.77 (0.74–0.80)

 ARB

1.16 (1.12–1.21)

0.92 (0.89–0.95)

0.66 (0.62–0.70)

 MRA

1.74 (1.64–1.85)

1.36 (1.15–1.61)

1.15 (1.10–1.22)

1.23 (1.14–1.32)

 Loop diuretics

1.10 (1.06–1.15)

1.78 (1.61–1.97)

1.33 (1.28–1.38)

1.87 (1.78–1.97)

 Bendroflumethiazide

0.90 (0.86–0.93)

1.17 (1.06–1.30)

0.96 (0.92–0.99)

 Indapamide

0.84 (0.75–0.94)

 NSAID

1.21 (1.17–1.25)

1.30 (1.27–1.34)

 Antibiotics

1.57 (1.48–1.66)

1.50 (1.38–1.65)

Serum K+ level during index HK event, mmol/L

 5.0 to ≤ 5.5a

  > 5.5 to ≤ 6.0

1.39 (1.33–1.44)

1.07 (0.96–1.21)

1.10 (1.06–1.13)

1.41 (1.33–1.50)

  > 6.0b

1.34 (1.23–1.47)

1.47 (1.18–1.83)

1.63 (1.54–1.74)

3.27 (3.02–3.54)

  1. aOr Clinical Practice Research Datalink diagnosis code in the absence of laboratory results
  2. bOr Hospital Episode Statistics diagnosis code, regardless of serum K+ level
  3. ACE angiotensin-converting enzyme, ARB angiotensin II receptor blocker, BUN blood urea nitrogen, CI confidence interval, eGFR estimated glomerular filtration rate, HK hyperkalemia, K+ potassium, MRA mineralocorticoid receptor antagonist, NSAID nonsteroidal anti-inflammatory drug, REF reference value