Evidence map›Paper›PMID 31517144›Full record

ArticleKidney international reports2019

Hyperkalemia in Real-World Patients Under Continuous Medical Care in Japan.

Naoki Kashihara, Shun Kohsaka, Eiichiro Kanda, Suguru Okami, Toshitaka Yajima

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PubMed Full text at PMC Publisher
In one paragraph

Article in Kidney international reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Naoki KashiharaDepartment of Nephrology and Hypertension, Kawasaki Medical School, Okayama, Japan.
Shun KohsakaDepartment of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Eiichiro KandaMedical Science, Kawasaki Medical School, Okayama, Japan.
Suguru OkamiCardiovascular, Renal, and Metabolism, Medical Affairs, AstraZeneca K.K., Osaka, Japan.
Toshitaka YajimaCardiovascular, Renal, and Metabolism, Medical Affairs, AstraZeneca K.K., Osaka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAn abnormal serum potassium (S-K) level is an important electrolyte disturbance. However, its relation to clinical outcomes in real-world patients, particularly hyperkalemia burden, is not extensively studied.

methodsAn observational retrospective cohort study using a Japanese hospital claims database was done (April 2008-September 2017;

resultsHyperkalemia prevalence was 67.9 (95% confidence interval [CI]: 67.1-68.8) per 1000 and increased in patients with chronic kidney disease (CKD) (227.9; 95% CI: 224.3-231.5), heart failure (134.0; 95% CI: 131.2-136.8), and renin-angiotensin-aldosterone system inhibitor (RAASi) use (142.2; 95% CI: 139.6-144.7). U-shaped associations between S-K level and 3-year survival were observed with nadir 4.0 mEq/l. The risk of death was increased at S-K 5.1-5.4 mEq with hazard ratio of 7.6 (95% CI: 7.2-8.0). The 3-year mortality rate in patients with CKD stages 3a, 3b, 4, and 5 with normokalemia were 1.51%, 3.93%, 10.86%, and 12.09%, whereas that in patients with CKD stage 3a at S-K 5.1-5.4, 5.5-5.9, and ≥6.0 mEq/l increased to 10.31%, 11.43%, and 22.64%, respectively. Despite treatment with loop diuretics (18.5%) and potassium binders (5.8%), >30% of patients had persistently high S-K (≥5.1 mEq/l).

conclusionThis study provides real-world insight on hyperkalemia based on a large number of patients with various medical backgrounds.

Indexed as

chronic kidney diseasecongestive heart failurehyperkalemiarenin-angiotensin-aldosterone inhibitorrenin angiotensin system

Identifiers

PMID31517144
PMCPMC6734103

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