Risk Factors, Epidemiology, and Patient Burden Associated With Hyperkalemia

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EP: 1.Risk Factors, Epidemiology, and Patient Burden Associated With Hyperkalemia

This content is a production of Drug Topics; this Pharmacist Video is supported by funding from AstraZeneca. AstraZeneca was not involved in the creation of the content for this Video.

Hyperkalemia, or elevated potassium levels, is a relatively uncommon issue in the general population, affecting only about 2% to 3%. However, in acute care and hospitalized settings, it becomes significantly more prevalent, with roughly 10% of admitted patients experiencing it. The risk is notably higher among individuals with chronic kidney disease, particularly those also managing heart failure. The condition is often driven not only by underlying pathophysiology but also by the pharmacologic treatments used to manage these illnesses. Common drugs such as renin-angiotensin-aldosterone system inhibitors, potassium-sparing diuretics, nonsteroidal anti-inflammatory drugs, and mineralocorticoid receptor antagonists can all elevate potassium levels, especially when kidney function is impaired, making careful monitoring essential.

From a clinical standpoint, the burden of hyperkalemia affects treatment decisions. Clinicians may hesitate to fully optimize lifesaving medications, particularly for heart failure patients, out of fear of triggering hyperkalemia. This can result in suboptimal therapy, leading to poorer health outcomes and avoidable hospitalizations. While the clinical perspective often focuses on treatment limitations and risk mitigation, this approach doesn’t fully capture the patient’s lived experience or the broader impacts of the condition.

For patients, the burden of hyperkalemia extends beyond medical risks to daily life disruptions. They often face conflicting dietary advice, leading to anxiety and confusion about what they can safely eat. Managing potassium intake becomes a constant concern, impacting both the individual and their caregivers. In more severe cases, patients may require dialysis, which entails a significant time commitment and further lifestyle constraints. This complexity highlights the need for clinicians to consider both clinical guidelines and the holistic experience of the patient when managing hyperkalemia.