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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