Olry de Labry Lima, AntonioDíaz Castro, ÓscarRomero-Requena, Jorge MGarcía Díaz-Guerra, M de Los ReyesArroyo Pineda, Virginiade la Hija Díaz, M BelénAscanio, MeritxellDarbà, JosepCruzado, Josep M2025-01-072025-01-072021-04-072048-8505https://hdl.handle.net/10668/24710Hyperkalaemia (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. 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 36 months. 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 €5929, reaching €12 705 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. 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.enAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/chronic kidney diseasediabetesheart failurehyperkalaemiarenin–angiotensin–aldosterone system inhibitorsresearch article34754435open access10.1093/ckj/sfab076PMC8573009https://academic.oup.com/ckj/article-pdf/14/11/2391/41100053/sfab076.pdfhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8573009/pdf