门诊患者高钾血症的患病率和风险因素

IF 1.7 Q3 UROLOGY & NEPHROLOGY

International Journal of Nephrology Pub Date : 2024-01-22 DOI:10.1155/2024/5694131

Chadapa Sevamontree, Supreeya Jintajirapan, Pran Phakdeekitcharoen, B. Phakdeekitcharoen

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引用次数: 0

摘要

背景。在门诊和急诊中，高钾血症是一种危及生命的疾病。高钾血症与更多的主要不良心血管疾病、住院和死亡事件有关。本研究旨在研究和评估泰国人口中高钾血症的患病率和风险因素。研究方法在医学门诊部对一个日历年（2021 年）内至少进行过一次有效血清钾（SK）检测的 3299 名成年患者（≥18 岁）进行横断面观察研究。SK≥5.8 mmol/L，且无溶血或技术误差，即为高钾血症。收集临床数据和实验室检测结果以分析风险因素。结果2 971 名患者（131 名高钾血症患者和 2 840 名对照组患者）符合条件。高钾血症的年发病率为 4.41%。高钾血症组患者的平均年龄为 66.5 岁，对照组为 55.9 岁。年龄的增加与高钾血症风险呈正相关（r = 0.220，p<0.001），而估计肾小球滤过率（eGFR）与 SK 水平呈反相关（r = -0.398，p<0.001）。高钾血症的风险因素包括：年龄≥65 岁（几率比为 2.106；95% CI 为 1.399，3.171；p<0.001）、患有糖尿病（DM，几率比为 1.541；95% CI 为 1.030，2.306；p=0.036）、慢性肾脏病（CKD）≥3 期（几率比为 14.885；95% CI 为 1.030，2.306；p=0.036）。885；95% CI，8.112，27.313；P<0.001）、血液透析治疗（几率比，10.170；95% CI，5.858，17.657；P<0.001）和使用肾素-血管紧张素-醛固酮系统抑制剂（RAASi，几率比，2.256；95% CI，1.440，3.536；P<0.001）。结论导致高钾血症的风险因素包括患者年龄较大、患有糖尿病、慢性肾脏病、接受血液透析治疗以及使用 RAASi。尽管使用 RAASi 被证明对老年人、DM 和 CKD 患者的心血管有利，但仍强烈建议对 SK 进行仔细监测，以优化患者护理。

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The Prevalence and Risk Factors of Hyperkalemia in the Outpatient Setting

Background. Hyperkalemia is a life-threatening condition in outpatient and emergency departments. Hyperkalemia is associated with more events of major adverse cardiovascular diseases, hospitalization, and death. The aim of this study is to study and assess the prevalence and risk factors for developing hyperkalemia within the Thai population. Method. A cross-sectional observational study of 3,299 unique adult patients (≥18 years) in one calendar year (2021) with at least 1 valid serum potassium (SK) test was conducted in the outpatient department of medicine. Hyperkalemia was determined as SK ≥5.8 mmol/L without hemolysis or technical error. Clinical data and laboratory tests were collected for analysis of risk factors. Result. 2,971 patients (131 hyperkalemia and 2,840 control) were eligible. The annual prevalence of hyperkalemia was 4.41%. The mean ages of patients were 66.5 years in the hyperkalemia group and 55.9 years in the control group. Increasing age had a positive association (r = 0.220, p<0.001) to risk of hyperkalemia, whereas the estimated glomerular filtration rate (eGFR) had an inverse association with SK level (r = −0.398, p<0.001). The risk factors for hyperkalemia were patients with age ≥65 years (odds ratio, 2.106; 95% CI, 1.399, 3.171; p<0.001), presence of diabetes mellitus (DM, odds ratio, 1.541; 95% CI, 1.030, 2.306; p=0.036), chronic kidney disease (CKD) stage ≥3 (odds ratio, 14.885; 95% CI, 8.112, 27.313; p<0.001), hemodialysis treatment (odds ratio, 10.170; 95% CI, 5.858, 17.657; p<0.001), and usage of renin-angiotensin-aldosterone system inhibitors (RAASi, odds ratio, 2.256; 95% CI, 1.440, 3.536; p<0.001). Conclusion. The risk factors contributing to hyperkalemia were patients with older age, DM, CKD, hemodialysis treatment, and usage of RAASi. Although the usage of RAASi is proven to be a cardiovascular advantage in the elderly, DM, and CKD patients, careful monitoring of SK is strongly advised to optimize patient care.

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来源期刊

International Journal of Nephrology UROLOGY & NEPHROLOGY-

CiteScore

3.40

自引率

4.80%

发文量

审稿时长

17 weeks

期刊介绍： International Journal of Nephrology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies focusing on the prevention, diagnosis, and management of kidney diseases and associated disorders. The journal welcomes submissions related to cell biology, developmental biology, genetics, immunology, pathology, pathophysiology of renal disease and progression, clinical nephrology, dialysis, and transplantation.