Observational studyJournal of nephrology2022
Association between hyperkalemia, RAASi non-adherence and outcomes in chronic kidney disease.
Observational study in Journal of nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
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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.
The trial behind it
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Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Medication adherence tools and measures in chronic kidney disease: a systematic review.BMC nephrology · 2026Pooled it
- Pooled it
- Discontinuation of Renin-Angiotensin System Inhibitors and Clinical Outcomes in Chronic Kidney Disease: A Systemic Review and Meta-Analysis.American journal of nephrology · 2023Pooled it
- Article
- Nephrotic syndrome in children: A review.Medicine · 2026Review
- What to do with key cardiovascular drugs when kidney function worsens?Clinical kidney journal · 2026Review
- Sodium Zirconium Cyclosilicate Duration and Hyperkalemia-Related Healthcare Encounters in Patients with Heart Failure and Cardio/Renal Dysfunction: The GALVANIZE Outcome Study.Drugs - real world outcomes · 2025Article
- Renin-Angiotensin-Aldosterone System Inhibitor Dosing After Initiation of Outpatient Sodium Zirconium Cyclosilicate Therapy: The GALVANIZE RAASi Real-World Evidence Study.Advances in therapy · 2025Article
- The burden of hyperkalaemia in chronic kidney disease: a systematic literature review.Clinical kidney journal · 2025Article
- Frequency, Management, and Outcomes of Outpatient Hyperkalemia: A Population-Based Cohort Study.Canadian journal of kidney health and disease · 2025Article
- Economic burden of recurrent hyperkalemia in patients with chronic kidney disease.Journal of managed care & specialty pharmacy · 2024Observational
- Clinical Outcomes in Patients with CKD and Rapid or Non-rapid eGFR Decline: A Report from the DISCOVER CKD Retrospective Cohort.Advances in therapy · 2024Article
- Hyperkalemia in chronic kidney disease patients with and without heart failure: an Italian economic modelling study.Cost effectiveness and resource allocation : C/E · 2024Article
- The Effects of Pharmacist-Led Medication Therapy Management on Medication Adherence and Use of Non-Steroidal Anti-Inflammatory Drug in Patients with Pre-End Stage Renal Disease.Patient preference and adherence · 2024Article
- Real-World Modifications of Renin-Angiotensin-Aldosterone System Inhibitors in Patients with Hyperkalemia Initiating Sodium Zirconium Cyclosilicate Therapy: The OPTIMIZE I Study.Advances in therapy · 2023Article
- Digital health technologies to support medication adherence in chronic kidney disease.Nephrology (Carlton, Vic.) · 2022Review
- Chronic Hyperkaliemia in Chronic Kidney Disease: An Old Concern with New Answers.International journal of molecular sciences · 2022Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHyperkalemia is relatively frequent in CKD patients treated with renin-angiotensin-aldosterone-system inhibitors (RAASi).
aimThe aim of the present study was to estimate the increased risk of cardiovascular events and mortality due to sub-optimal adherence to RAASi in CKD patients with hyperkalemia.
methodsAn observational retrospective cohort study was conducted, based on administrative and laboratory databases of five Local Health Units. Adult patients discharged from the hospital with a diagnosis of CKD, who were prescribed RAASi between January 2010 and December 2017, were included. We evaluated the appearance of documented episodes of hyperkalemia, RAASi therapy adherence and the effects of these two variables on cardiovascular events, death and dialysis inception for study patients.
resultsOf the 9241 selected patients, 4451 met all the criteria for study inclusion. Among them, 1071 had at least one documented episode of hyperkalemia, while 3380 did not. After propensity score matching based on several variables we obtained 2 groups of patients. The appearance of hyperkalemia caused treatment discontinuation in 21.8% of patients previously on RAASi therapy, and sub-optimal adherence (proportion of days covered < 80%) in 33.6% of them. Non-adherence to RAASi therapy among hyperkalemia patients was associated with a higher risk of cardiovascular events (hazard ratio [HR] 1.45, confidence interval [CI] 1.02-2.08; p < 0.05). Moreover, in non-adherent hyperkalemia patients, the risk of death increased by 126% (HR 2.26, CI 1.62-3.15; p < 0.001) compared with adherent patients.
conclusionsIn a large cohort of CKD patients treated with RAASi, we observed that following hyperkalemia onset, non-adherence to RAASi medication can result in an increased risk of cardiovascular events and death.
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