ArticleJournal of clinical medicine2018
Competing-Risk Analysis of Death and End Stage Kidney Disease by Hyperkalaemia Status in Non-Dialysis Chronic Kidney Disease Patients Receiving Stable Nephrology Care.
Article in Journal of clinical medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Management of hyperkalemia in patients with kidney disease: a position paper endorsed by the Italian Society of Nephrology.Journal of nephrology · 2019Guideline
- Residual Renal Risk in Diabetic Nephropathy Despite Contemporary Therapies.Journal of clinical medicine · 2026Review
- Simple methods for estimating the maximum 24-hour urinary potassium excretion in kidney failure without replacement therapy patients.Renal failure · 2025Article
- Economic Evaluation of Patiromer in Patients with Concomitant Heart Failure and Chronic Kidney Disease in Italy.PharmacoEconomics - open · 2025Article
- Hyperkalemia management: a multidisciplinary expert panel's perspective on the role of new potassium binders.Heart failure reviews · 2025Review
- A noninvasive hyperkalemia monitoring system for dialysis patients based on a 1D-CNN model and single-lead ECG from wearable devices.Scientific reports · 2025Article
- Artificial intelligence in chronic kidney diseases: methodology and potential applications.International urology and nephrology · 2025Review
- The burden of hyperkalaemia on hospital healthcare resources.Clinical and experimental medicine · 2024Observational
- Recent Progresses in Non-Dialysis Chronic Kidney Disease Patients with Hyperkalemia: Outcomes and Therapeutic Strategies.Medicina (Kaunas, Lithuania) · 2023Review
- Heart Failure Pharmacological Management: Gaps and Current Perspectives.Journal of clinical medicine · 2023Article
- Hyperkalemia in CKD: an overview of available therapeutic strategies.Frontiers in medicine · 2023Review
- Digital health technologies to support medication adherence in chronic kidney disease.Nephrology (Carlton, Vic.) · 2022Review
- Hyperkalaemia in Heart Failure: Consequences for Outcome and Sequencing of Therapy.Current heart failure reports · 2022Review
- Chronic Hyperkaliemia in Chronic Kidney Disease: An Old Concern with New Answers.International journal of molecular sciences · 2022Review
- Association between hyperkalemia, RAASi non-adherence and outcomes in chronic kidney disease.Journal of nephrology · 2022Observational
- Hyperkalemia in Chronic Kidney Disease: Links, Risks and Management.International journal of nephrology and renovascular disease · 2022Review
- Patterns of chronic and transient hyperkalaemia and clinically important outcomes in patients with chronic kidney disease.Clinical kidney journal · 2022Article
- OMICS in Chronic Kidney Disease: Focus on Prognosis and Prediction.International journal of molecular sciences · 2021Review
- Epidemiology of hyperkalemia in CKD patients under nephrological care: a longitudinal study.Internal and emergency medicine · 2021Article
- Review
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hyperkalaemia burden in non-dialysis chronic kidney disease (CKD) under nephrology care is undefined. We prospectively followed 2443 patients with two visits (referral and control with 12-month interval) in 46 nephrology clinics. Patients were stratified in four categories of hyperkalaemia (serum potassium, sK ≥ 5.0 mEq/L) by sK at visit 1 and 2: Absent (no-no), Resolving (yes-no), New Onset (no-yes), Persistent (yes-yes). We assessed competing risks of end stage kidney disease (ESKD) and death after visit 2. Age was 65 ± 15 years, eGFR 35 ± 17 mL/min/1.73 m², proteinuria 0.40 (0.14⁻1.21) g/24 h. In the two visits sK was 4.8 ± 0.6 and levels ≥6 mEq/L were observed in 4%. Hyperkalaemia was absent in 46%, resolving 17%, new onset 15% and persistent 22%. Renin-angiotensin-system inhibitors (RASI) were prescribed in 79% patients. During 3.6-year follow-up, 567 patients reached ESKD and 349 died. Multivariable competing risk analysis (sub-hazard ratio-sHR, 95% Confidence Interval-CI) evidenced that new onset (sHR 1.34, 95% CI 1.05⁻1.72) and persistent (sHR 1.27, 95% CI 1.02⁻1.58) hyperkalaemia predicted higher ESKD risk versus absent, independently from main determinants of outcome including eGFR change. Conversely, no effect on mortality was observed. Results were confirmed by testing sK as continuous variable. Therefore, in CKD under nephrology care, mild-to-moderate hyperkalaemia status is common (37%) and predicts per se higher ESKD risk but not mortality.
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Registered trials
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