Table 2.
Pooled mean prevalence for all adult studies, healthcare settings, geographical areas and subgroups stratified by HK definition/threshold
| HK by any definition/threshold | >5.0 mmol/L | ≥5.5 mmol/L | ≥6.0 mmol/L | |
|---|---|---|---|---|
| All adult studies (n) | 478 | 193 | 221 | 87 |
| Percentage of population affected (95% CI) | 6.3 (5.8–6.8) | 8.0 (7.2–8.9) | 5.9 (3.5–10.0) | 1.0 (0.8–1.4) |
| I2-test for heterogeneity | 100% | 100% | 100% | 99.9% |
| General population | 39 | 20 | 15 | 5 |
| 1.3 (1.0–1.8) | 3.8 (3.2–4.4) | 1.3 (0.9–1.9) | 0.4 (0.2–0.9) | |
| 100% | 100% | 100% | 100% | |
| Sex | ||||
| Male | 134 | 68 | 64 | 17 |
| 6.3 (4.9–8.0) | 9.0 (7.2–11.2) | 6.5 (4.5–9.4) | 1.6 (0.6–4.1) | |
| 100% | 100% | 100% | 100% | |
| Female | 132 | 67 | 64 | 16 |
| 5.1 (4.0–6.6) | 7.4 (5.9–9.1) | 5.3 (3.8–7.5) | 1.4 (0.5–3.6) | |
| 100% | 100% | 100% | 100% | |
| Study type | ||||
| Single centre | 304 | 92 | 139 | 52 |
| 9.9 (9.1–10.9) | 13.3 (11.8–14.9) | 11.1 (9.7–12.8) | 5.1 (3.6–7.1) | |
| 99.6% | 99.5% | 99.6% | 99.9% | |
| Multi-centre/registry/database | 223 | 106 | 92 | 45 |
| 5.1 (4.6–5.6) | 8.5 (7.6–9.6) | 5.4 (4.5–6.4) | 2.0 (1.5–2.5) | |
| 100% | 100% | 100% | 99.9% | |
| Healthcare setting | ||||
| Outpatient/primary care | 251 | 110 | 105 | 49 |
| 5.0 (4.5–5.5) | 8.7 (7.8–9.8) | 5.9 (4.9–7.1) | 1.7 (1.3–2.3) | |
| 100% | 100% | 100% | 99.9% | |
| Emergency admissions | 49 | 15 | 18 | 7 |
| 7.7 (6.1–9.8) | 10.5 (8.1–13.7) | 10.4 (7.4–14.7) | 2.3 (1.5–3.5) | |
| 99.8% | 99.7% | 99.8% | 99.3% | |
| Hospital inpatients | 144 | 40 | 65 | 17 |
| 8.7 (7.8–9.7) | 12.5 (10.1–15.5) | 8.6 (7.4–9.9) | 7.5 (5.4–10.5) | |
| 99.9% | 99.9% | 99.8% | 99.5% | |
| Intensive carea | 28 | 14 | 13 | 4 |
| 7.1 (5.9–8.6) | 7.9 (6.5–9.7) | 6.6 (4.1–10.6) | 6.5 (4.4–9.4) | |
| 99.7% | 99.5% | 99.5% | 98.7% | |
| Dialysisb | 48 | 14 | 22 | 11 |
| 20.7 (17.4–24.7) | 28.4 (22.6–35.6) | 21.2 (19.3–23.4) | 12.2 (9.8–15.2) | |
| 100% | 100% | 99.5% | 99.6% | |
| Haemodialysis | 38 | 11 | 18 | 10 |
| 23.1 (19.1–28.0) | 36.2 (28.4–46.2) | 23.4 (21.2–25.7) | 12.9 (10.3–16.3) | |
| 100% | 100% | 99.5% | 99.6% | |
| Peritoneal dialysis | 9 | 4 | 4 | 2 |
| 11.4 (7.7–16.9) | 13.8 (8.1–23.4) | 12.3 (5.1–29.6) | 4.3 (0.5–35.4) | |
| 99.1% | 99.4% | 98.8% | 98.9% | |
| Continent | ||||
| Africa | 14 | 5 | 3 | 1 |
| 21.8 (14.4–32.9) | 12.1 (6.5–22.5) | 36.7 (24.0–55.9) | 11.5 (6.2–21.3) | |
| 92.6% | 88.0% | 81.6% | - | |
| Asia | 148 | 41 | 54 | 8 |
| 10.4 (9.2–11.7) | 11.6 (9.7–13.9) | 11.2 (7.9–15.8) | 9.4 (4.2–20.8) | |
| 99.9% | 100% | 99.9% | 99.7% | |
| Australasia | 9 | 3 | 3 | 3 |
| 10.1 (8.4–12.0) | 23.3 (21.0–25.8) | 7.3 (5.2–10.4) | 4.6 (3.3–6.5) | |
| 99.5% | 97.9% | 99.1% | 99.2% | |
| Europe | 175 | 79 | 80 | 39 |
| 5.9 (5.3–6.6) | 7.8 (6.8–9.0) | 7.3 (6.0–9.0) | 2.8 (1.9–4.2) | |
| 100% | 100% | 99.9% | 99.9% | |
| North America | 176 | 59 | 72 | 29 |
| 5.0 (4.4–5.8) | 9.3 (7.9–11.0) | 5.4 (4.4–6.6) | 1.6 (1.2–2.3) | |
| 100% | 100% | 100% | 99.9% | |
| South America | 14 | 4 | 9 | 5 |
| 13.4 (10.2–17.5) | 22.8 (12.3–42.6) | 14.9 (10.7–20.9) | 6.2 (3.7–10.5) | |
| 96.7% | 98.3% | 96.0% | 86.7% | |
| Globalc | 10 | 4 | 5 | 4 |
| 6.7 (4.1–11.0) | 16.5 (3.5–58.0) | 8.9 (3.9–20.6) | 3.5 (2.7–4.5) | |
| 100% | 100% | 100% | 98.8% | |
| Comorbidity | ||||
| CKD non-dialysisd | 119 | 57 | 54 | 21 |
| 8.5 (7.8–9.3) | 14.6 (12.7–16.8) | 8.9 (7.6–10.4) | 2.5 (1.9–3.3) | |
| 99.9% | 99.9% | 99.9% | 99.7% | |
| End-stage kidney diseasee | 60 | 17 | 29 | 12 |
| 21.5 (18.3–25.3) | 33.3 (27.2–40.7) | 23.0 (21.0–25.2) | 11.6 (9.4–14.3) | |
| 100% | 99.9% | 99.4% | 99.6% | |
| Kidney transplant | 18 | 2 | 7 | 4 |
| 21.8 (16.1–29.5) | 21.8 (7.0–60.8) | 30.8 (20.1–47.2) | 12.7 (6.1–26.4) | |
| 98.4% | 88.5% | 98.2% | 92.9% | |
| Diabetes mellitus | 64 | 37 | 29 | 11 |
| 5.3 (4.2–6.6) | 8.4 (6.3–11.3) | 7.2 (4.9–10.8) | 1.3 (0.7–2.3) | |
| 99.9% | 99.9% | 100% | 99.5% | |
| Heart failure | 104 | 49 | 53 | 23 |
| 6.5 (5.6–7.7) | 8.6 (6.7–11.0) | 8.0 (6.5–9.8) | 3.1 (2.3–4.2) | |
| 99.9% | 99.9% | 99.7% | 99.2% | |
| Hypertension | 39 | 17 | 13 | 2 |
| 4.7 (3.9–5.7) | 5.1 (3.8–6.8) | 3.6 (2.6–4.9) | 2.8 (0.5–16.5) | |
| 99.9% | 99.9% | 99.9% | 84.8% | |
| AKI | 28 | 7 | 11 | 3 |
| 24.3 (19.3–30.7) | 25.7 (16.1–41.2) | 31.8 (21.4–47.3) | 7.8 (3.5–17.5) | |
| 99.5% | 99.7% | 98.8% | 98.6% | |
| COVID-19 infection | 7 | |||
| 10.4 (6.8–15.9) | ||||
| 74.8% | ||||
| Medications | ||||
| RAASif | 151 | 53 | 67 | 31 |
| 5.8 (5.1–6.6) | 9.7 (8.3–11.5) | 7.9 (6.6–9.5) | 2.5 (1.7–3.7) | |
| 99.9% | 99.9% | 99.8% | 99.7% | |
| ACEi | 49 | 18 | 25 | 9 |
| 5.0 (4.0–6.2) | 7.9 (5.8–10.8) | 7.6 (5.7–10.0) | 2.0 (0.8–5.4) | |
| 99.9% | 99.9% | 99.4% | 99.4% | |
| ARB | 66 | 25 | 27 | 8 |
| 5.5 (4.1–7.3) | 6.7 (4.8–9.3) | 8.5 (6.2–11.7) | 3.2 (1.1–9.3) | |
| 99.9% | 99.9% | 99.4% | 99.4% | |
| ACEI/ARB plus MRA | 9 | 1 | 8 | 2 |
| 14.6 (9.6–22.0) | 11.2 (8.7–14.5) | 12.8 (7.3–22.2) | 21.9 (16.9–28.4) | |
| 95.8% | One study | 96.9% | 0% | |
| MRA | 54 | 20 | 22 | 12 |
| 8.9 (7.2–11.0) | 10.1 (7.3–14.1) | 11.6 (8.7–15.3) | 5.9 (3.9–9.0) | |
| 99.1% | 98.6% | 96.4% | 96.5% | |
| Diuretics | 22 | 13 | 10 | 2 |
| 6.6 (5.2–8.3) | 8.1 (6.4–10.4) | 5.5 (3.0–10.2) | 1.3 (0.2–8.2) | |
| 99.5% | 99.4% | 99.6% | 97.3% | |
| CNI | 8 | |||
| 19.4 (10.8–34.9) | ||||
| 97.6% |
a
Includes patients admitted to coronary care units and high dependency areas.
b
Only includes studies performed in an outpatient dialysis population and includes patients on both haemodialysis and peritoneal dialysis.
c
Includes studies performed across different continents.
d
Includes patients with pre-dialysis CKD 5 (estimated glomerular filtration rate <15 mL/min/1.73 m2.)
e
Includes patients from ANY study setting receiving kidney-replacement therapy but NOT pre-dialysis CKD 5 or those with a kidney transplant.
f
Includes patients taking ACEi, ARB, renin inhibitors and MRAs.
Empty cells are where no data were available. COVID-19, coronavirus disease 2019.