Abstract: FR-PO545
Hyperkalaemia in Patients Receiving Renin-Angiotensin-Aldosterone System Blockade: Clinical Epidemiology and Outcomes
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid‚ Electrolyte‚ and Acid-Base Disorders
- 1002 Fluid‚ Electrolyte‚ and Acid-Base Disorders: Clinical
Authors
- Yap, Desmond, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
- So, Yu Fai Benjamin, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
- Lee, Chi Ho Paul, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
- Hai, Siu Han Jojo, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
- Chan, Tak Mao Daniel, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
Background
Hyperkalaemia is a common side effect of patients receiving renin-angiotensin-aldosterone system (RAAS) blockade, but its prevalence and clinical impact can vary between different localities due to differences in diets and patient characteristics. Data regarding the epidemiology and outcomes of hyperkalaemia in Asian patients is relatively limited.
Methods
We analyzed all patients receiving RAAS blockade at Queen Mary Hospital, Hong Kong during 2018-2021 and identified patients with hyperkalaemia. The prevalence and clinical outcomes of patients with or without hyperkalaemia were compared.
Results
A total of 14,206 patients were analysed, including 6085 (42.8%), 5849 (41.2%) and 379 (2.7%) patients on angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB) and mineralocorticoid receptor antagonists (MRA) respectively. 1893 patients (13.3%) received dual or triple RAAS blockade. Hyperkalaemia occurred in 3959 (27.9%) patients. 1647 patients (11.6%) died during follow up, and 3-year mortality rate was significantly higher in patients with hyperkalaemia compared with those without (25.5% vs. 6.2%, p<0.001). 616 patients (4.3%) had major cardiovascular events (MACE), and patients with hyperkalaemia showed increased rates of MACE compared to those without hyperkalaemia (7.8% vs. 3.0%, p<0.001). Patients with hyperkalaemia also showed more rapid deterioration of eGFR compared with those without hyperkalaemia (2.8±6.0 ml/min/year vs. 1.3±4.3 ml/min/year, p<0.001). 314 patients (2.2%) developed end-stage kidney disease (ESKD) during a follow up of 3 years, and the incidence of ESKD was significantly higher in patients with hyperkalaemia (6.2% vs. 0.7%, p<0.001).
Conclusion
Hyperkalaemia is highly prevalent among Asian patients receiving RAAS blockade and is associated with unfavourable clinical outcomes.