Collins AJ, et al. - This study sheds light on the link between serum potassium, mortality, and conditions commonly associated with dyskalemias, such as heart failure (HF), chronic kidney disease (CKD), and/or diabetes mellitus (DM). Findings reported a progressive rise in mortality risk with dyskalemia. Data also demonstrated that mortality risk was differentially greater in those with HF, CKD, or DM.

Methods

• Researchers reviewed electronic medical record data from a geographically diverse population (n = 911,698) receiving medical care, studied the distribution of serum potassium, and the link between an index potassium value and mortality over an 18-month period in those with and without HF, CKD, and/or DM.
• They assessed the link between all-cause mortality and potassium using a cubic spline regression analysis in the total population, a control group, and in HF, CKD, DM, and a combined cohort.

Results

• Findings demonstrated that 27.6% had a potassium <4.0 mEq/L, and 5.7% had a value ≥5.0 mEq/L.
• Researchers observed a U-shaped association between serum potassium and mortality in all groups, with lowest all-cause mortality in controls with potassium values between 4.0 and <5.0 mEq/L.  
• They also noted that all-cause mortality rates per index potassium between 2.5 and 8.0 mEq/L were consistently greater with HF 22%, CKD 16.6%, and DM 6.6% vs. controls 1.2%, and highest in the combined cohort 29.7%.
• Data revealed that higher mortality rates were noted in those aged ≥65 vs. 50-64 years.
• In an adjusted model, it was seen that all-cause mortality was significantly elevated for every 0.1 mEq/L change in potassium <4.0 mEq/L and ≥5.0 mEq/L.
• In addition, results showed that diuretics and renin-angiotensin-aldosterone system inhibitors were related to hypokalemia and hyperkalemia respectively.