Dyskalemia, its patterns, and prognosis among patients with incident heart failure: A nationwide study of US veterans

PloS One
Kunihiro MatsushitaMiklos Z Molnar

Abstract

Although hypokalemia has been viewed as a significant concern among patients with heart failure (HF), recent advances in HF management tend to increase the risk of hyperkalemia. To characterize contemporary data regarding correlates and prognostic values of dyskalemia in patients with HF. In cross-sectional and longitudinal analyses, we studied 142,087 patients with newly diagnosed HF in US nationwide Veterans Administration database from 2005 through 2013. Demographic characteristics, laboratory variables, comorbidities, and medication use for the analysis of correlates of dyskalemia as well as potassium level in the analysis of mortality. Dyskalemia and mortality. Hypokalemia (<3.5 mmol/L) at baseline was observed in 3.0% of the population, whereas hyperkalemia (≥5.5 mmol/L) was seen in 0.9%. An additional 20.4% and 5.7% had mild hypokalemia (3.5-3.9 mmol/L) and mild hyperkalemia (5.0-5.4 mmol/L). Key correlates were black race, higher blood pressure, and use of potassium-wasting diuretics for hypokalemia, and lower kidney function for hyperkalemia. Baseline potassium levels showed a U-shaped association with mortality, with the lowest risk between 4.0-4.5 mmol/L. With respect to potassium levels over a year after HF diagnosi...Continue Reading

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Citations

Jun 6, 2020·Journal of the American Heart Association·Tommaso FilippiniMarco Vinceti
Jun 6, 2020·Journal of the American College of Cardiology·João Pedro FerreiraFaiez Zannad

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