Table 3.
Pooled mean incidence rate 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) | 65 | 22 | 32 | 19 |
| Incidence—cases per 100-person years (95% CI) | 2.7 (2.3–3.3) | 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 | 5 | 3 | 2 | 2 |
| 0.3 (0.1–0.7) | 1.5 (1.1–2.1) | 0.6 (0.4–0.9) | (0.1–0.2) | |
| 100% | 99.9% | 100% | 98.3% | |
| Study type | ||||
| Single centre | 13 | 5 | 9 | 6 |
| 7.7 (4.8–12.3) | 13.9 (10.0–19.2) | 20.7 (7.6–56.9) | 1.5 (0.4–6.3) | |
| 99.7% | 99.0% | 99.8% | 99.6% | |
| Multi-centre/registry/database | 52 | 17 | 23 | 13 |
| 2.2 (1.8–2.7) | 7.1 (6.3–8.0) | 4.0 (2.2–7.3) | 0.9 (0.7–1.2) | |
| 100% | 100% | 100% | 100% | |
| Healthcare settinga | ||||
| Outpatient/primary care | 54 | 21 | 26 | 16 |
| 2.3 (2.1–2.7) | 8.7 (7.8–9.7) | 3.4 (2.9–4.0) | 0.9 (0.7–1.1) | |
| 100% | 100% | 100% | 99.9% | |
| Hospital inpatients | 4 | 3 | 1 | |
| 3.7 (1.4–9.6) | 5.1 (1.2–22.3) | 0.7 (0.6–0.8) | ||
| 99.9% | 98.7% | One study | ||
| Dialysisc | 5 | 3 | 2 | |
| 55.3 (25.1–121.7) | 153.8 (84.5–279.9) | 222.8 (1.6–106.3) | ||
| 100% | 100% | 99.9% | ||
| Continentb | ||||
| Asia | 14 | 2 | 1 | |
| (0.8–2.9) | 3.8 (0.9–15.9) | 0.7 (0.6–0.8) | ||
| 99.9% | 98.6% | One study | ||
| Australasia | 1 | 1 | 1 | |
| 5.8 (4.4–7.6) | 7.1 (5.2–9.7) | 4.7 (3.1–7.0) | ||
| One study | One study | One study | ||
| Europe | 25 | 15 | 19 | 8 |
| 4.1 (3.4–4.9) | 10.2 (8.8–11.9) | 4.1 (3.5–4.9) | 1.1 (0.8–1.6) | |
| 100% | 100% | 99.9% | 99.9% | |
| North America | 24 | 5 | 10 | 8 |
| 2.3 (1.5–3.6) | 6.2 (5.3–7.3) | 9.1 (3.7–22.2) | 0.7 (0.4–1.2) | |
| 100% | 99.9% | 100% | 99.9% | |
| Globald | 1 | 1 | 1 | |
| 9.0 (3.8–21.5) | 14.0 (13.8–14.3) | 5.8 (5.6–6.0) | ||
| 100% | One study | One study | ||
| Comorbidity | ||||
| CKD non-dialysise | 27 | 13 | 13 | 7 |
| 4.2 (3.5–4.9) | 8.7 (7.7–9.8) | 5.9 (4.7–7.4) | 2.5 (1.9–3.3) | |
| 100% | 99.9% | 99.9% | 99.7% | |
| End-stage kidney diseasef | 7 | 1 | 4 | 3 |
| 30.0 (14.5–61.9) | 8.3 (7.9–8.6) | 104.1 (56.3–193.6) | 9.8 (2.4–40.4) | |
| 100% | One study | 100% | 99.9% | |
| Kidney transplant | 3 | 2 | 1 | 2 |
| 4.7 (3.0–7.2) | 16.9 (12.0–23.6) | 22.0 (15.0–32.4) | 0.6 (0.5–0.9) | |
| 99.3% | 98.9% | One study | 76.5% | |
| Diabetes mellitus | 14 | 7 | 6 | 4 |
| (0.7–1.8) | 5.0 (2.5–10.1) | 3.5 (1.8–7.0) | 0.8 (0.4–1.5) | |
| 100% | 100% | 99.9% | 99.7% | |
| Heart failure | 19 | 10 | 14 | 8 |
| 4.3 (3.1–6.0) | 13.3 (8.6–20.6) | 4.2 (2.9–5.9) | 1.4 (0.8–2.5) | |
| 100% | 100% | 99.9% | 99.8% | |
| Hypertension | 6 | 2 | 3 | 1 |
| 3.0 (1.8–5.0) | 12.1 (3.0–48.7) | 2.1 (1.6–2.8) | 0.6 (0.5–0.6) | |
| 100% | 93.8% | 97.9% | One study | |
| Medications | ||||
| RAASig | 38 | 10 | 17 | 9 |
| 1.7 (1.4–2.1) | 7.6 (6.7–8.7) | 3.6 (2.3–5.6) | 0.9 (0.5–1.7) | |
| 100% | 99.9% | 99.9% | 99.9% | |
| ACEi | 12 | 2 | 4 | 3 |
| 0.7 (0.4–1.1) | 12.3 (8.0–18.9) | 1.3 (0.7–2.3) | 0.4 (0.2–1.1) | |
| 99.9% | 99.8% | 99.5% | 99.0% | |
| ARB | 20 | 4 | 8 | 4 |
| (0.8–2.1) | 8.1 (5.2–12.8) | 3.2 (1.3–8.1) | 0.8 (0.2–2.8) | |
| 99.9% | 99.8% | 99.8% | 99.5% | |
| ACEi/ARB | 31 | 9 | 15 | 9 |
| 1.3 (1.1–1.8) | 7.3 (6.5–8.1) | 3.7 (2.3–5.9) | 1.0 (0.5–1.8) | |
| 100% | 99.8% | 99.9% | 99.9% | |
| MRA | 9 | 2 | 4 | 1 |
| 4.0 (0.2–71.7) | 9.9 (2.9–33.6) | 4.0 (0.9–18.0) | 0.3 (0.2–0.4 | |
| 99.6% | 99.8% | 99.4% | One study | |
| Diuretics | 3 | 3 | ||
| 4.0 (0.2–71.7) | 4.0 (0.2–71.7) | |||
| 99.9% | 99.9% | |||
| CNI | 4 | 4 | ||
| 7.1 (0.8–66.2) | 7.1 (0.8–66.2) | |||
| 99.7% | 99.7% |
There were no emergency or intensive care studies reporting incidence.
There were no studies reporting incidence in Africa or South America.
Only includes studies performed in an outpatient dialysis population. There were no studies reporting incidence of HK in peritoneal dialysis patients, results are specific to patients on haemodialysis.
Includes studies performed across different continents.
Includes patients with pre-dialysis CKD 5 (estimated glomerular filtration rate <15 mL/min/1.73 m2.)
Includes patients receiving kidney-replacement therapy from ANY study setting but NOT pre-dialysis CKD 5 or those with a kidney transplant.
Includes patients taking ACEi, ARB, renin inhibitors and MRAs.
Empty cells are where no data were available.