Hyperkalemia, also in acute heart failure

Jacob, J.; Llauger, L.; Gil, V.; Javaloyes, P.

doi:10.1016/j.rceng.2018.11.009

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Hernáez et al.<a class="elsevierStyleCrossRef" href="#bib0030">1</a> highlights the high rate of hyperkalemia (potassium levels ≥5.5mmol/L) in patients with heart failure with reduced ejection fraction (HFrEF), with a rate of 17,100 cases among the 508,000 estimated patients in Spain and a predominance of men (10,000 patients). The authors underscore the importance of this health problem when withdrawing treatments that improve survival for these patients. It is noteworthy that, as far as we can tell, this study is based on data for stable heart failure (HF); however, the authors did not provide data on HF with preserved ejection fraction (HFpEF) or on acute heart failure (AHF). The presence of hyperkalemia in AHF also affects the decision-making process in emergency departments. Our workgroup has data from the Epidemiology of Acute Heart Failure in Spanish Emergency Departments registry on 13,791 patients with AHF between 2007 and 2016. The registry's work practices have previously been described.<a class="elsevierStyleCrossRefs" href="#bib0035">2–5</a> Based on a cohort of 11,935 patients with AHF and available data on the estimated glomerular filtration rate and potassium levels during acute episodes (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), 835 (7.0%) patients presented hyperkalemia, and it was more common in the population who presented an estimated glomerular filtration rate <60mL/min (685 patients, 82.0%). The ejection fraction was recorded for 6475 patients, 1406 (21.7%) of whom had HF with reduced ejection fraction (HFrEF). The presence of hyperkalemia was more common in HFrEF than in HFpEF (118/1406 [8.4%] vs. 302/5069 [6.0%]; raw odds ratio, 1.45 [95% CI 1.16–1.81]; p<.001). In conclusion, hyperkalemia in AHF also has a high prevalence and is more often associated with renal failure and HFrEF.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Jacob J, Llauger L, Gil V, Javaloyes P. Hiperpotasemia, también en la insuficiencia cardiaca aguda. Rev Clin Esp. 2019;219:103–104." ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1801 "Ancho" => 2500 "Tamanyo" => 201123 ] ] "descripcion" => array:1 [ "en" => "Prevalence of hyperkalemia in the Epidemiology of Acute Heart Failure in Emergency Departments cohort." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia e incidencia de hiperpotasemia en población espãnola con insuficiencia cardiaca con fracción de eyección deprimida: revisión sistemática y relevancia poblacional" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Á. Hernáez" 1 => "J.F. Delgado" 2 => "J. Cinca" 3 => "F. Fernández-Avilés" 4 => "J. Marrugat" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rce.2018.01.006" "Revista" => array:6 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2018" "volumen" => "218" "paginaInicial" => "253" "paginaFinal" => "260" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29496276" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impacto de las variables geriátricas en la mortalidad a 30 días de los ancianos atendidos por insuficiencia cardiaca aguda" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F.J. Martín-Sánchez" 1 => "E. Rodríguez-Adrada" 2 => "M.T. Vidan" 3 => "P. Díez Villanueva" 4 => "G. Llopis García" 5 => "J. González Del Castillo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Emergencias" "fecha" => "2018" "volumen" => "30" "paginaInicial" => "149" "paginaFinal" => "155" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29687668" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Atención prehospitalaria a los pacientes con insuficiencia cardiaca aguda en España: estudio SEMICA" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "O. Miró" 1 => "P. Llorens" 2 => "X. Escalada" 3 => "P. Herrero" 4 => "J. Jacob" 5 => "V. Gil" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Emergencias" "fecha" => "2017" "volumen" => "29" "paginaInicial" => "223" "paginaFinal" => "230" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28825276" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Características clínicas, terapéuticas y evolutivas de los pacientes con insuficiencia cardiaca aguda atendidos en servicios de urgencias españoles: Registro EAHFE (Epidemiology of Acute Heart Failure in Spanish Emergency Departments)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Llorens" 1 => "R. Escoda" 2 => "O. Miró" 3 => "P. Herrero-Puente" 4 => "F.J. Martín-Sánchez" 5 => "J. Jacob" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Emergencias" "fecha" => "2015" "volumen" => "27" "paginaInicial" => "11" "paginaFinal" => "22" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29077328" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Time trends in characteristics, clinical course, and outcomes of 13,791 patients with acute heart failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Llorens" 1 => "P. Javaloyes" 2 => "F.J. Martín-Sánchez" 3 => "J. Jacob" 4 => "P. Herrero-Puente" 5 => "V. Gil" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00392-018-1261-z" "Revista" => array:6 [ "tituloSerie" => "Clin Res Cardiol" "fecha" => "2018" "volumen" => "107" "paginaInicial" => "897" "paginaFinal" => "913" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29728831" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021900000002/v1_201902270625/S2254887418301887/v1_201902270625/en/main.assets" "Apartado" => array:4 [ "identificador" => "71813" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Correspondence" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021900000002/v1_201902270625/S2254887418301887/v1_201902270625/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887418301887?idApp=WRCEE"]

Revista Clínica Española (English Edition)

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Vol. 219. Issue 2.

Pages 103-104 (March 2019)

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