Evidence map›Paper›PMID 34104453›Full record

ArticleCanadian journal of kidney health and disease2021

Initial and Recurrent Hyperkalemia Events in Patients With CKD in Older Adults: A Population-Based Cohort Study.

Sriram Sriperumbuduri, Eric McArthur, Gregory L Hundemer, Mark Canney, Navdeep Tangri, Silvia J Leon, Sara Bota, Ann Bugeja, Ayub Akbari, Greg Knoll and 1 more

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In one paragraph

Article in Canadian journal of kidney health and disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

9 citing papers in PubMed.

  1. Article
  2. Hyperkalemia Is an Underestimated Risk Factor in COPD.International journal of chronic obstructive pulmonary disease · 2025
    Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Review
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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

11 authors.

Sriram SriperumbuduriDepartment of Medicine, University of Ottawa, ON, Canada.
Eric McArthurOttawa Hospital Research Institute, ON, Canada.
Gregory L HundemerDepartment of Medicine, University of Ottawa, ON, Canada.
Mark CanneyDepartment of Medicine, University of Ottawa, ON, Canada.
Navdeep TangriChronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, MB, Canada.
Silvia J LeonChronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, MB, Canada.ORCID https://orcid.org/0000-0003-0006-9596
Sara BotaOttawa Hospital Research Institute, ON, Canada.
Ann BugejaDepartment of Medicine, University of Ottawa, ON, Canada.ORCID https://orcid.org/0000-0002-4106-0451
Ayub AkbariDepartment of Medicine, University of Ottawa, ON, Canada.
Greg KnollDepartment of Medicine, University of Ottawa, ON, Canada.
Manish M SoodDepartment of Medicine, University of Ottawa, ON, Canada.ORCID https://orcid.org/0000-0002-9146-2344

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe risk of hyperkalemia is elevated in chronic kidney disease (CKD); however, the initial and recurrent risk among older individuals is less clear.

objectivesWe set out to examine the initial and 1-year recurrent risk of hyperkalemia by level of kidney function (estimated glomerular filtration rate, eGFR) in older adults (≥66 years old).

designPopulation-based, retrospective cohort study. SETTINGS: Ontario, Canada.

participants905 167 individuals (≥66 years old) from 2008 to 2015. MEASUREMENTS: Serum potassium values.

methodsIndividuals were stratified by eGFR (≥90, 60-89, 30-59, 15-29 mL/min/1.73 m

resultsAmong a population of 905 167 individuals (15% eGFR ≥ 90, 58% eGFR 60-89, 25% eGFR 30-59, 3% eGFR 15-29) with a potassium measurement, there were a total of 18 979 (2.1%) individuals with hyperkalemia identified. The event rate (per 1000 person-years) and adjusted hazard ratio (HR) of hyperkalemia was inversely associated with eGFR (mL/min; eGFR >90 mL/min: 8.8, referent, 60-89 mL/min: 11.8 HR 1.41; eGFR 30-59: 39.8, HR 4.37; eGFR 15-29: 133.6, 13.65) and with an increasing urine albumin-to-creatinine ratio (ACR, mg/mmol; ACR< 3: 14, referent, ACR 3-30: 35.1, HR 1.98; ACR >30: 93.7, 4.71). The 1-year event rate and adjusted risk of recurrent hyperkalemia was similarly inversely associated with eGFR (eGFR ≥ 90: 10.1, referent, eGFR 60-89: 14.4, HR 1.47; eGFR 30-59: 54.8, HR 4.90; eGFR 15-29: 208.0, HR 12.98). Among individuals with a baseline eGFR of 30 to 59 and 15 to 29, 0.9 and 3.8% had greater than 2 hyperkalemia events. The relative risk of initial and recurrent hyperkalemia was marginally higher with RAAS blockade. Roughly 1 in 4 individuals with hyperkalemia required hospitalization the day of or within 30 days after their hyperkalemia event. LIMITATIONS: Limited to individuals aged 66 years and above.

conclusionsPatients with low eGFR are at a high risk of initial and recurrent hyperkalemia.

trial registration

Indexed as

albuminuriachronic kidney diseaseeGFRepidemiologyhyperkalemiaRAAS

Identifiers

PMID34104453
PMCPMC8165829

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.