Introduction:
Chronic kidney disease (CKD) is commonly associated with a variety of adverse adverse outcomes, including an increased risk of cardiovascular events (CVD) and events (CVD) and mortality. One of the challenges in the management of CKD, especially in patients undergoing maintenance hemodialysis (HD), is the prevention of hyperkalemia.
This condition, generally defined as serum potassium (K+) levels greater than 5.5 mmol/l, can persist even when patients are receiving regular when patients receive regular and adequate HD treatment three times a week. per week. Hyperkalemia is a serious and potentially lethal disorder, capable of causing cardiac arrhythmias. of cardiac arrhythmias and, in extreme cases, sudden cardiac death.
Methods:
A retrospective cohort study was carried out including patients over 18 years of age, with renal support therapy in intermittent hemodialysis with a total of 9 hours per week, who had presented some degree of hyperkalemia defined as mild (> 5.5-5.9 mmol/L), moderate (6-6.4 mmol/L) and severe (>6.5 mmol/L), and some major cardiovascular outcome with a total of 9 hours per week. severe (>6.5 mmol/L) and at the same time some major cardiovascular outcome with follow-up by the Nephrology service at the Regional General Hospital No. 46, during the period January 2023 to June 2023.
Results:
The 66.5% were men and 37.5% were women. With respect to comorbidities, 21.4% of the patients had a diagnosis of diabetes mellitus, while a 92.6% had systemic arterial hypertension. Analyzing the causes of CKD,in 146 patients (70.9%) the cause was unknown. In 28 patients (13.6%) CKD was associated with diabetes, in 14 patients (6.8%) with glomerulopathies, in 9 patients (4.45%) withpatients (4.45%) to pregnancy, in 6 patients (2.9%) to obstructive causes and in 3 patients (1.5%) to neonatal nephropathy.patients (1.5%) to tubulointerstitial nephritis. Of the patients, 54.8% were receivingtreatment with ACEI/ARA II. The most common vascular access was arteriovenous fistula (AVF), arteriovenous fistula (AVF), present in 41.6% of cases.
Cardiovascular outcomes occurred in 39.9% of the total number of patients. patients. A lower percentage of cardiovascular events was observed in patients with normal potassium levels. patients with normal potassium levels (21.8%). However, as the potassium level potassium level increased, the percentage of cardiovascular events increased. cardiovascular outcomes: mild hyperkalemia (46.2%), moderate (48.6%) and severe (68.8%). severe with 68.8%, this difference being statistically significant.
During the 6-month follow-up period, sudden deaths were recorded in 4 patients, occurringpatients, occurring mainly in those with mild and moderate hyperkalemia. moderate hyperkalemia. This is in agreement with previous literature, which indicates that, although there were only 4 deaths, the main cause of mortality was related to cardiovascular events. cardiovascular events
Conclusions:
Despite receiving optimal timing of renal support therapy, more than half of the patients experienced some degree ofhyperkalemia. This study confirms the existence of a direct relationship between the degree of hyperkalemia and the increased incidence of adverse cardiovascular outcomes. Among these, heart failure was the most prevalent and showed a statistically significant relationship with elevated levels of potassium.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.