At least one hyperkalemia episode is associated with mortality and disease progression in stage 3 CKD patients

Excerpt

Hyperkalemia is a common and dangerous complication of chronic kidney disease (CKD), and its prevalence increases as CKD progresses [1]. Hyperkalemia usually results from impaired glomerular filtration rate (GFR) and/or tubular dysfunction, and is potentiated by several medical conditions frequently associated with CKD. Additionally, a broad spectrum of drugs constitute a risk factor for hyperkalemia. Renin–angiotensin–aldosterone system inhibitors (RAASis), which are frequently used for their renal and cardioprotective effects, represent an important cause of hyperkalemia frequently leading to discontinuation of therapy [2‐5]. Recent research suggests that hyperkalemia is consistently associated with higher mortality in non-dialysis CKD patients [1‐3]. However, the association between hyperkalemia and renal outcomes is still controversial. The impact of hyperkalemia on CKD progression may be more evident at earlier stages and interventions at this level may also be more effective, as stage 3 CKD patients will probably reap greater benefit from RAAS inhibition than patients with advanced CKD. Our goal was to investigate the association between at least one hyperkalemia episode, all-cause mortality and CKD progression in a CKD stage 3 outpatient population. …