{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T04:36:24Z","timestamp":1781238984670,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T00:00:00Z","timestamp":1617148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hyperkalaemia is a potential life\u2010threatening electrolyte abnormality. Although renin\u2010angiotensin\u2010aldosterone system inhibitors (RAASi) are potentially life\u2010saving, they may contribute to hyperkalaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The prevalence, comorbidities, comedications and 1\u2010year outcomes of patients admitted or treated for hyperkalaemia were investigated in a large healthcare administrative database including 12\u00a0533\u00a0230 general population inhabitants. A similar analysis was performed in the Italian Network on Heart Failure (IN\u2010HF), a cardiology registry of 1726 acute and 7589 chronic HF patients, stratified by serum potassium. General practice healthcare costs related to hyperkalaemia were also assessed. Hyperkalaemia was defined by hospital coding, potassium\u2010binder prescription or serum levels (mild: 5\u20105.4, moderate\u2010severe: \u22655.5\u00a0mmol\/L).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the general population, the prevalence of hyperkalaemia was 0.035%. After excluding patients on haemodialysis, hyperkalaemia in the community (n\u00a0=\u00a02314) was significantly and directly associated with diabetes, chronic kidney disease, HF, RAASi prescriptions, 1\u2010year hospitalisations and threefold annual healthcare costs, compared to age\u2010 and sex\u2010matched non\u2010hyperkalaemic subjects (n\u00a0=\u00a02314). In the IN\u2010HF registry, hyperkalaemia affected 4.3% of acute and 3.6% of chronic patients and was significantly associated with diabetes, kidney disease and lesser use of RAASi, compared to normokalaemic patients. Among patients hospitalised for acute HF, those with hyperkalaemia at entry had significantly higher 1\u2010year all\u2010cause mortality compared with normokalaemic patients, even after adjustment for available confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hyperkalaemia in the general population, although uncommon, was associated with increased hospitalisations and tripling of healthcare costs. Among HF patients, hyperkalaemia was common and associated with underuse of RAASi; in acutely decompensated patients, it remained independently associated with 1\u2010year all\u2010cause mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13551","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T07:50:24Z","timestamp":1617177024000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Prevalence, clinical impact and costs of hyperkalaemia: Special focus on heart failure"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2764-6779","authenticated-orcid":false,"given":"Aldo P.","family":"Maggioni","sequence":"first","affiliation":[{"name":"Research and Health Foundation Fondazione Ricerca e Salute (ReS) Rome Italy"},{"name":"ANMCO Research Center Fondazione per il Tuo cuore Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Dondi","sequence":"additional","affiliation":[{"name":"Research and Health Foundation Fondazione Ricerca e Salute (ReS) Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicita","family":"Andreotti","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. 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