Analysis of Hyperkalemia Inducing Factors in Patient with Chronic Renal Failure

Kim, Ok Ki; Sin, Min Ho; Kang, Young Un; Park, Pyung Kyun; Bae, Woo Kyun; Lee, Kyun Sang; Bae, Eun Hwi; Park, Jeong Woo; Ma, Seoung Kwon; Kim, Soo Wan; Kim, Nam Ho; Choi, Ki Chul

Abstract

Hyperkalemia commonly occurs in acute and chronic renal insufficiency patients. The authors sought to find out primary factors and causes of hyperkalemia in non-hemodialytic chronic renal insufficiency patients. Since January 2004, we reviewed the patients whose glomerular filtration ratio (GFR) ranged 15~60 ml/ min and with no dialysis done. Follow-up observations were done over six months at least. Hyperkalemia is defined as serum potassium > or = 5.5 mEq/L. The cause of hyperkalemia is evaluated by means of the records of medical history, laboratory data, present illness, and past history. The number of patients observed was 115 in total and those who suffered from hyperkalemia among them were 68 (59%). Meaningful differences found between the non-hyperkalemia group and hyperkalemia group were: GFR 32.3+/-13.2 ml/min and 29.0+/-10.1 ml/min (p=0.02); the chronic kidney disease (CKD) stage 4 (69%) and diabetes (69%) were significantly higher (p=0.001) in hyperkalemia group; and the ventricular ejection fraction (VEF) below 48% were 23% and 49% (p=0.006). The prominent cause of hyperkalemia was the medicine administered. Even if the GFR is no less than 15 ml/min, physicians should pay careful attention in selecting therapeutic agents for there is diabetes, low GFR and low VEF. These patients are also required to have regular electrolyte check-ups for prevention of hyperkalemia.