Observational study reveals high mortality and costs in undetected hyperkalemia in adults, highlighting widespread underdiagnosis despite severe clinical risks.
Key Points
To assess the prevalence, clinical characteristics, management, outcomes, healthcare resource utilization, and costs associated with diagnosed versus undetected hyperkalemia.
Observational cross-sectional and retrospective study using electronic health records from the BIG-PAC database in Spain covering 608,514 adults between January 2013 and December 2020.
Identified 7,006 adults with potassium >5.0 mmol/L, a hyperkalemia diagnostic code, or hyperkalemia treatment, who had at least 2 years of follow-up.
Defined undetected hyperkalemia as potassium >5.0 mmol/L at the index date without an associated diagnosis code or recorded treatment.
Hyperkalemia prevalence was 1.15%, with undetected cases accounting for two-thirds of the total burden (0.77% prevalence); among undetected patients, 35.8% had moderate and 5.4% had severe hyperkalemia.
Patients with undetected versus diagnosed hyperkalemia experienced lower comorbidity rates of chronic kidney disease (10.8% vs 42.4%, p<0.001) and atherosclerotic cardiovascular disease (20.0% vs 24.1%, p<0.001).
Patients with undetected hyperkalemia experienced substantial clinical events compared to diagnosed patients, including mortality (10.9% vs 18.8%, p<0.001), annual hospitalizations (15.6% vs 33.1%, p<0.001), and annual costs (€5,005 vs €7,615, p<0.001).