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Incidence of hyperkalemia in the emergency department: a 10-year retrospective study

  • Loïc Lemoine
  • Quentin Le Bastard
  • Damien Masson
  • François Javaudin
  • Eric Batard
  • Emmanuel MontassierEmail author
CE - LETTER TO THE EDITOR

To the Editor,

Hyperkalemia, or high serum potassium, is a common electrolyte disorder. Normal levels of serum potassium range from 3.5 to 4.5 mmol/L, with hyperkalemia defined by a value of 4.5 mmol/L or higher, and severe hyperkalemia, defined as a serum potassium level of 6.0 mmol/L or higher [1]. People with chronic diseases such as chronic kidney disease, heart failure, hypertension or diabetes mellitus are at a particularly high risk of developing hyperkalemia [1, 2]. In patients with chronic kidney disease, incidence of hyperkalemia is estimated to be 3.2% [3], and 2.5% [4] in elderly adults with chronic kidney disease. However, data on hyperkalemia frequency in the ED are sparse. A retrospective 2-year study in Switzerland, investigating 29,250 potassium measurements showed that 2585 patients (8.8%) had hyperkalemia, and 88 (0.3% of all patients) with a serum potassium value exceeding 5.9 mmol/L [5]. To estimate the incidence of hyperkalemia, we performed a retrospective...

Abbreviations

ED

Emergency department

Notes

Author contributions

LL, EM, and DM conceived the study. LL, EM, FJ and EB developed the analysis plan, and LL undertook the main analysis with supervision from EM, DM and QLB. EM and LL wrote the first draft of the paper, with all the other authors making important critical revisions. All the authors have read and approved the final version of the manuscript.

Funding

No funding received for this work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Statement of human and animal rights

The study protocol was approved by the board of the Nantes University Hospital.

Informed consent

As it was a retrospective study of anonymized blood samples that were obtained as part of the routine activity of laboratory, informed consent was not required following French recommendations.

References

  1. 1.
    Schaefer TJ, Wolford RW (2005) Disorders of potassium. Emerg Med Clin N Am 23:723–747CrossRefGoogle Scholar
  2. 2.
    Rossignol P, Legrand M, Kosiborod M et al (2016) Emergency management of severe hyperkalemia: guideline for best practice and opportunities for the future. Pharmacol Res 113:585–591CrossRefGoogle Scholar
  3. 3.
    Einhorn LM, Zhan M, Hsu VD et al (2009) The frequency of hyperkalemia and its significance in chronic kidney disease. Arch Intern Med 169(12):1156–1162CrossRefGoogle Scholar
  4. 4.
    Drawz PE, Babineau DC, Rahman M (2012) Metabolic complications in elderly adults with chronic kidney disease. J Am Geriatr Soc 60(2):310–315CrossRefGoogle Scholar
  5. 5.
    Pfortmüller CA, Leichtle AB, Fiedler GM et al (2013) Hyperkalemia in the emergency department: etiology, symptoms and outcome of a life threatening electrolyte disorder. Eur J Intern Med 5:e59–e60CrossRefGoogle Scholar

Copyright information

© Società Italiana di Medicina Interna (SIMI) 2019

Authors and Affiliations

  • Loïc Lemoine
    • 1
  • Quentin Le Bastard
    • 1
    • 2
  • Damien Masson
    • 3
  • François Javaudin
    • 1
    • 2
  • Eric Batard
    • 1
    • 2
  • Emmanuel Montassier
    • 1
    • 2
    Email author
  1. 1.Department of Emergency MedicineNantes University Hospital, CHU NantesNantesFrance
  2. 2.MiHAR LabUniversité de NantesNantesFrance
  3. 3.Department of BiochemistryNantes University HospitalNantesFrance

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