Evidence map›Paper›PMID 40110488›Full record

ArticleInternational journal of chronic obstructive pulmonary disease2025

Hyperkalemia Is an Underestimated Risk Factor in COPD.

Jukka Mäenpää, Isobel Anderson, Caroline A Owen, Ulrika Emerath, Rod Hughes, Stefan R Sultana, Marita Olsson

Abstract read
In one paragraph

Article in International journal of chronic obstructive pulmonary disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Jukka MäenpääChief Medical Office, Research & Development, Patient Safety Biopharma, AstraZeneca, Gothenburg, Sweden.
Isobel AndersonPatient Safety Operations, Technology & Analytics, Global Patient Safety, AstraZeneca, Macclesfield, UK.
Caroline A OwenBioPharmaceuticals, Early Clinical Development, AstraZeneca, Gaithersburg, MD, USA.
Ulrika EmerathChief Medical Office, Research & Development, Patient Safety Biopharma, AstraZeneca, Gothenburg, Sweden.
Rod HughesBioPharmaceuticals Medical, AstraZeneca, Cambridge, UK.
Stefan R SultanaCardiovascular Safety Center of Excellence and Safety Knowledge Groups, Global Patient Safety, AstraZeneca, Cambridge, UK.
Marita OlssonBioPharma Late-Stage Development Respiratory & Immunology, Biometrics and Statistical Innovation, AstraZeneca, Gothenburg, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Hyperkalemia increases mortality in various patient populations. The risk of hyperkalemia in COPD patients is poorly recognized. Hyperkalemia may increase cardiovascular mortality during and soon after COPD exacerbations. Patients and Methods: A cohort based on two clinical trials comprising 7968 patients with moderate-to-very severe COPD was analysed retrospectively for associations between hyperkalemia and common comorbidities such as chronic kidney disease, diabetes mellitus (DM), or renin-angiotensin-aldosterone system inhibitor use. Results: Overall, 6.4% of 7968 patients had hyperkalemia (5.3% Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 2, 6.8% GOLD 3, and 8.0% GOLD 4). COPD severity was associated with significantly higher hyperkalemia risk in GOLD 3 (odds ratio [OR]=1.28, 95% CI 1.04-1.58) and GOLD 4 (OR=1.64, 95% CI 1.19-2.22) versus GOLD 2 patients. Hyperkalemia cases increased with decreasing renal function. Patients with moderate-to-severe renal impairment had >2-fold increased hyperkalemia risk versus those with normal renal function (OR=2.29, 95% CI 1.71-3.04). DM was associated with increased hyperkalemia risk (OR=1.28, 95% CI 1.02-1.59). Angiotensin-converting-enzyme inhibitor (ACEi) use increased hyperkalemia risk (OR=1.25, 95% CI 1.02-1.53). Unexpectedly, the association between hyperkalemia and renin-angiotensin-aldosterone system inhibitor use was statistically significant only in the normal renal function group (OR=1.63, 95% CI 1.13-2.34). Conclusion: Hyperkalemia risk is higher in severe and very severe COPD patients than patients with moderate COPD. Hyperkalemia was also associated with decreasing kidney function, DM, and ACEi use. Serum potassium levels should be monitored regularly in patients with COPD, particularly those with GOLD-3 and 4.

Indexed as

HyperkalemiaLungPotassiumPulmonary Disease, Chronic ObstructiveAgedAngiotensin-Converting Enzyme InhibitorsBiomarkersChi-Square DistributionComorbidityFemaleHumansKidneyLogistic ModelsMaleMiddle AgedOdds RatioAngiotensin-Converting Enzyme InhibitorsBiomarkersPotassiumangiotensin-converting-enzyme inhibitorcardiac arrhythmiaschronic kidney diseaserenin-angiotensin-aldosterone system inhibitorsserum bicarbonates

Identifiers

PMID40110488
PMCPMC11921801

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.