ALL-CAUSE MORTALITY ASSOCIATED WITH HYPERKALAEMIA IN HOSPITALISED ADULT PATIENTS: A SCOPING REVIEW

 

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https://storage.unitedwebnetwork.com/files/1099/85b26696ec27c6427e43d38205f77434.pdf
ALL-CAUSE MORTALITY ASSOCIATED WITH HYPERKALAEMIA IN HOSPITALISED ADULT PATIENTS: A SCOPING REVIEW

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Mogamat-Yazied
Chothia
Beate Boshoff beateboshoff8@gmail.com Stellenbosch University Division of Nephrology, Department of Medicine Cape Town South Africa -
Mogamat-Yazied Chothia yaziedc@sun.ac.za Stellenbosch University Division of Nephrology, Department of Medicine Cape Town South Africa *
 
 
 
 
 
 
 
 
 
 
 
 
 

While the association between hyperkalaemia and all-cause 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.

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/). 

Mortality rates with associated 95% confidence intervals of included studies and an overall estimateTwenty-two studies were included, encompassing 777 020 patients, of whom 78 685 (10.1%) had hyperkalaemia. The overall all-cause 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.

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.

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