Introduction: While the association between hyperkalaemia and allcause mortality has been described, existing evidence is fragmented and underrepresents populations from low-and middle-income countries.We conducted a scoping review to map existing research on hyperkalaemia-associated mortality in hospitalised adults and identify key gaps in the literature.Methods: This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis -Scoping Reviews.Studies from database inception to January 2025 were eligible for inclusion.The following bibliographic databases were searched: Medline (PubMed), CINHAL (EBSCOhost), and Web of Science (Clarivate).The final protocol was registered with the Open Science Framework (https://osf.io/etkap/).Results: Twenty-two studies were included, encompassing 777 020 patients, of whom 78 685 (10.1%) had hyperkalaemia.The overall allcause in-hospital mortality was 22.8% (95% CI 22.5-23.1%)(Figure).Frequent comorbidities were chronic kidney disease (43%), diabetes mellitus (26%), and congestive heart failure (23%).Acute kidney injury was associated with the highest mortality rate (41%).Serum potassium concentration (K + ) was a consistent independent predictor of death in 9 of 11 studies that conducted multivariate analysis; however, the correlation between K + and mortality was weak (r=0.248,p=0.489).Geographic representation was skewed, with only three studies conducted in Africa. Conclusion:This scoping review mapped current evidence on hyperkalaemia-associated all-cause mortality in hospitalised adults, and was high, especially with concurrent AKI.The K+, acute kidney injury, and age were the most common independent predictors of death.Future research should standardise definitions and expand geographic representation, particularly in Africa.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.
Mpungose et al. (Wed,) studied this question.