Serum potassium dynamics during acute heart failure hospitalization

Background Available information about prognostic implications of potassium levels alteration in the setting of acute heart failure (AHF) is scarce. Objectives We aim to describe the prevalence of dyskalemia (hypo or hyperkalemia), its dynamic changes during AHF-hospitalization, and its long-term cl...

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Published in:Clinical research in cardiology 2022-04, Vol.111 (4), p.368-379
Main Authors: Caravaca Perez, Pedro, González-Juanatey, José R., Nuche, Jorge, Morán Fernández, Laura, Lora Pablos, David, Alvarez-García, Jesús, Bascompte Claret, Ramón, Martínez Selles, Manuel, Vázquez García, Rafael, Martínez Dolz, Luis, Cobo-Marcos, Marta, Pascual Figal, Domingo, Crespo-Leiro, Maria G., Nuñez Villota, Julio, Cinca Cuscullola, Juan, Delgado, Juan F.
Format: Article
Language:English
Subjects:
Cardiology
Congestive heart failure
Heart failure
Hospitalization
Hyperkalemia
Hypokalemia
Medicine
Medicine & Public Health
Mortality
Original Paper
Patients
Potassium
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Summary:Background Available information about prognostic implications of potassium levels alteration in the setting of acute heart failure (AHF) is scarce. Objectives We aim to describe the prevalence of dyskalemia (hypo or hyperkalemia), its dynamic changes during AHF-hospitalization, and its long-term clinical impact after hospitalization. Methods We analyzed 1779 patients hospitalized with AHF who were included in the REDINSCOR II registry. Patients were classified in three groups, according to potassium levels both on admission and discharge: hypokalemia (potassium  5 mEq/L). Results The prevalence of hypokalemia and hyperkalemia on admission was 8.2 and 4.6%, respectively, and 6.4 and 2.7% at discharge. Hyperkalemia on admission was associated with higher in-hospital mortality (OR = 2.32 [95% CI: 1.04–5.21] p  = 0.045). Among patients with hypokalemia on admission, 79% had normalized potassium levels at discharge. In the case of patients with hyperkalemia on admission, 89% normalized kalemia before discharge. In multivariate Cox regression, dyskalemia was associated with higher 12-month mortality, (HR = 1.48 [95% CI, 1.12–1.96], p  = 0.005). Among all patterns of dyskalemia persistent hypokalemia (HR = 3.17 [95% CI: 1.71–5.88]; p  
ISSN:1861-0684
1861-0692
DOI:10.1007/s00392-020-01753-3