RT Journal Article
T1 Hyperkalaemia management and related costs in chronic kidney disease patients with comorbidities in Spain
A1 de Labry Lima, Antonio Olry
A1 Castro, Oscar Diaz
A1 Romero-Requena, Jorge M.
A1 Garcia Diaz-Guerra, M. de los Reyes
A1 Arroyo Pineda, Virginia
A1 de la Hija Diaz, M. Belen
A1 Ascanio, Meritxell
A1 Darba, Josep
A1 Cruzado, Josep M.
K1 chronic kidney disease
K1 diabetes
K1 heart failure
K1 hyperkalaemia
K1 renin-angiotensin-aldosterone system inhibitors
K1 Heart-failure
K1 Task-force
K1 Association
K1 Guidelines
K1 Esc
K1 Potassium
K1 Diagnosis
K1 Burden
K1 Update
K1 Impact
AB Background. Hyperkalaemia (HK) is a common electrolyte disorder in patients with chronic kidney disease (CKD) and/or treated with renin-angiotensin-aldosterone system inhibitors (RAASis). The aim of this study is to determine the severity, current management and cost of chronic HK.Methods. We performed a retrospective cohort study of patients with chronic HK and CKD, heart failure or diabetes mellitus between 2011 and 2018. The study follow-up was 36months.Results. A total of 1499 patients with chronic HK were analysed: 66.2% presented with mild HK, 23.4% with moderate HK and 10.4% with severe HK. The severity was associated with CKD stage. Most patients (70.4%) were on RAASi therapies, which were frequently discontinued (discontinuation rate was 39.8, 49.8 and 51.8% in mild, moderate and severe HK, respectively). This RAASi discontinuation was similar with or without resin prescription. Overall, ion-exchange resins were prescribed to 42.5% of patients with HK and prescriptions were related to the severity of HK, being 90% for severe HK. Adherence to resin treatment was very low (36.8% in the first year and 17.5% in the third year) and potassium remained elevated in most patients with severe HK. The annual healthcare cost per patient with HK was Euro5929, reaching Euro12 705 in severe HK. Costs related to HK represent 31.9% of the annual cost per HK patient and 58.8% of the specialized care cost.Conclusions. HK was usually managed by RAASi discontinuation and ion-exchange resin treatment. Most patients with HK were non-adherent to resins and those with severe HK remained with high potassium levels, despite bearing elevated healthcare expenditures.
PB Oxford univ press
SN 2048-8505
YR 2021
FD 2021-04-07
LK https://hdl.handle.net/10668/24711
UL https://hdl.handle.net/10668/24711
LA en
DS RISalud
RD Apr 17, 2025