Table 4.
Hyperkalemia treatment at the time of index hyperkalemia and during the follow-up period
| Treatment | Overall n = 25,395 | CKD n = 14,322 | DM n = 12,101 | HF n = 8570 | HTN n = 16,463 |
|---|---|---|---|---|---|
| Hyperkalemia treatment on index date, n (%) | |||||
| Thiazide diuretics | 539 (2.1) | 452 (3.2) | 357 (3.0) | 236 (2.8) | 520 (3.2) |
| Loop diuretics | 4698 (18.5) | 3289 (23.0) | 2404 (19.9) | 3271 (38.2) | 3732 (22.7) |
| Glucose injection+insulina | 562 (2.2) | 298 (2.1) | 285 (2.4) | 278 (3.2) | 299 (1.8) |
| Calcium gluconate | 547 (2.2) | 267 (1.9) | 204 (1.7) | 235 (2.7) | 282 (1.7) |
| Sodium bicarbonate | 707 (2.8) | 598 (4.2) | 330 (2.7) | 247 (2.9) | 521 (3.2) |
| Potassium binder | 1468 (5.8) | 1308 (9.1) | 825 (6.8) | 543 (6.3) | 1171 (7.1) |
| SPS | 404 (1.6) | 354 (2.5) | 208 (1.7) | 139 (1.6) | 304 (1.8) |
| CPS | 1264 (5.0) | 1145 (8.0) | 732 (6.0) | 518 (6.0) | 1045 (6.3) |
| Medications associated with hyperkalemia, n (%) | |||||
| RAASi treatment | 10,212 (40.2) | 6785 (47.4) | 5979 (49.4) | 4856 (56.7) | 9453 (57.4) |
| ACEi | 2028 (8.0) | 1334 (9.3) | 1143 (9.4) | 1226 (14.3) | 1844 (11.2) |
| ARB | 7518 (29.6) | 5230 (36.5) | 4687 (38.7) | 3012 (35.1) | 7254 (44.1) |
| MRA | 3161 (12.4) | 2020 (14.1) | 1562 (12.9) | 2412 (28.1) | 2683 (16.3) |
| non-RAASi | 5093 (20.1) | 2193 (15.3) | 2039 (16.8) | 1446 (16.9) | 2735 (16.6) |
| Beta-blockers | 863 (3.4) | 440 (3.1) | 418 (3.5) | 482 (5.6) | 608 (3.7) |
| Cyclosporin | 120 (0.5) | 67 (0.5) | 52 (0.4) | 24 (0.3) | 44 (0.3) |
| Digoxin | 162 (0.6) | 66 (0.5) | 74 (0.6) | 95 (1.1) | 103 (0.6) |
| Heparin | 1896 (7.5) | 741 (5.2) | 690 (5.7) | 593 (6.9) | 915 (5.6) |
| NSAIDs | 1721 (6.8) | 611 (4.3) | 631 (5.2) | 336 (3.9) | 754 (4.6) |
| Potassium supplements | 253 (1.0) | 86 (0.6) | 88 (0.7) | 95 (1.1) | 126 (0.8) |
| Tacrolimus | 57 (0.2) | 21 (0.1) | 25 (0.2) | 11 (0.1) | 19 (0.1) |
| Hyperkalemia treatment during the follow-up period, n (%) | |||||
| Any treatment | 18,595 (73.2) | 12,031 (84.0) | 9641 (79.7) | 7492 (87.4) | 12,839 (78.0) |
| Potassium binder | 6087 (24.0) | 5392 (37.6) | 3303 (27.3) | 2235 (26.1) | 4574 (27.8) |
| Low daily dose | 6084 (100.0)b | 5389 (100.0) | 3301 (99.9) | 2233 (99.9) | 4571 (99.9) |
| Initiation of diuretics | 6491 (25.6) | 4366 (30.5) | 2983 (24.7) | 2338 (27.3) | 4194 (25.5) |
| RAASi treatment before index hyperkalemia | 10,212 (40.2) | 6785 (47.4) | 5979 (49.4) | 4856 (56.7) | 9453 (57.4) |
| Discontinuation of RAASi | 5480 (53.7)c | 3654 (53.9) | 2722 (45.5) | 2628 (54.1) | 4286 (45.3) |
| Dose reduction of RAASi | 1336 (13.1)c | 960 (14.1) | 736 (12.3) | 779 (16.0) | 1210 (12.8) |
ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blockers; CKD, chronic kidney disease; CPS, calcium polystyrene sulfonate; DM, diabetes mellitus; HF, heart failure; HTN, hypertension; MRA, mineral corticoid receptor antagonist; NSAID, nonsteroidal anti-inflammatory drug; RAASi, renin-angiotensin-aldosterone inhibitors; SPS, sodium polystyrene sulfonate.
a
Glucose injection + insulin was counted only when the glucose injection was used concomitantly with insulin on the same day.
b
The denominator was the number of patients using potassium binders (n = 6087).
c
The denominator was the number of patients using RAASis (n = 10,212).