Evidence map›Paper›PMID 38687454›Full record

Observational studyAdvances in therapy2024

Hyperkalemia Recurrence Following Medical Nutrition Therapy in Patients with Stage 3-4 Chronic Kidney Disease: The REVOLUTIONIZE I Real-World Study.

Christopher G Rowan, Abiy Agiro, K Arnold Chan, Ellen Colman, Katie White, Pooja Desai, Jamie P Dwyer

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Advances in therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Review
  2. Hyperkalemia in Severe Burn Injuries: Pathogenesis and Therapeutic Advances.Journal of community hospital internal medicine perspectives · 2026
    Review
  3. Observational
  4. Article
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

7 authors.

Christopher G RowanPharmacoepidemiology, COHRDATA, INC, 4030 Calle Marlena, San Clemente, CA, 92672, USA. crowan@cohrdata.com.
Abiy AgiroUS Evidence, US Medical Affairs, AstraZeneca, Wilmington, DE, USA.
K Arnold ChanTriNetX, LLC, Cambridge, MA, USA.
Ellen ColmanUS Renal, US Medical Affairs, AstraZeneca, Wilmington, DE, USA.
Katie WhiteTriNetX, LLC, Cambridge, MA, USA.
Pooja DesaiUS Renal, US Medical Affairs, AstraZeneca, Wilmington, DE, USA.
Jamie P DwyerDepartment of Internal Medicine, University of Utah, Salt Lake City, UT, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe REVOLUTIONIZE I study aimed to characterize the relationships between medical nutrition therapy (MNT) and hyperkalemia recurrence in patients with stage 3-4 chronic kidney disease (CKD) and hyperkalemia who received MNT in real-world clinical practice.

methodsThis observational cohort study used de-identified electronic health record data from patients aged ≥ 18 years with stage 3-4 CKD who received MNT between January 2019 and October 2022 and had hyperkalemia (serum potassium > 5.0 mmol/L) within 30 days before MNT. Patients were followed for 6 months or until the first censoring event (death, prescription of outpatient potassium binder, or study end). The primary outcome was the percentage of patients with ≥ 1 hyperkalemia recurrence during follow-up. Secondary outcomes included the number of hyperkalemia recurrences per patient, time to each recurrence, and hyperkalemia-related healthcare resource utilization. Exploratory outcomes included all-cause healthcare resource utilization and mortality.

resultsThe final cohort comprised 2048 patients; 1503 (73.4%) patients remained uncensored after 6 months. During the 6-month follow-up period, 56.0% of patients had ≥ 1 hyperkalemia recurrence and 37.4% had ≥ 1 recurrence within the first month. Patients with ≥ 1 hyperkalemia recurrence during follow-up had a mean ± standard deviation (SD) of 2.6 ± 2.2 recurrences. The mean ± SD time to first hyperkalemia recurrence was 45 ± 46 days; the time between recurrences decreased with subsequent episodes. Hyperkalemia-related hospitalizations and emergency department visits were recorded for 13.7% and 1.5% of patients, respectively. Sensitivity analyses showed that results were consistent across patient subgroups, including those with comorbid heart failure and patients receiving renin-angiotensin-aldosterone system inhibitor therapy at baseline.

conclusionMost patients with stage 3-4 CKD had hyperkalemia recurrence, and MNT alone was inadequate to prevent recurrence. These patients may require additional long-term treatment, such as novel potassium binders, to maintain normokalemia and prevent hyperkalemia recurrence following MNT. Infographic available for this article. INFOGRAPHIC.

Indexed as

HyperkalemiaRecurrenceRenal Insufficiency, ChronicAgedCohort StudiesFemaleHumansMaleMiddle AgedNutrition TherapyChronic kidney diseaseDietary counsellingHealthcare resource utilizationHeart failureHyperkalemiaMedical nutrition therapyPotassiumRenal dysfunctionRenin–angiotensin–aldosterone system inhibitor

Identifiers

PMID38687454
PMCPMC11133091

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LicenceCC BY-NC
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Registered trials

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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.