{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:41:19Z","timestamp":1791520879296,"version":"4.3.4"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,1,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">This real\u2010world evidence study compared risks of cardiovascular events in hospital settings among patients with chronic kidney disease (CKD) with and without hyperkalemia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Adults with CKD stages 3b\/4 with and without hyperkalemia were identified from Optum's deidentified Market Clarity Data (January 2016\u2013August 2022). Patients with hyperkalemia were exact and propensity score matched to patients without hyperkalemia. The index date was the first CKD stage 3b\/4 diagnosis with \u22651 hyperkalemia diagnosis and \u22651 serum potassium &gt;5.0\u2009mmol\/L in the preceding 12\u2009months (baseline) for patients with hyperkalemia and a randomly selected CKD stage 3b\/4 diagnosis for controls. Cardiovascular composite end points included major adverse cardiovascular events plus (a composite end point of all\u2010cause mortality, myocardial infarction, stroke, or heart failure) and cardiac arrhythmias (a composite end point of new onset atrial fibrillation and other atrial and ventricular arrythmias), all in the hospital setting. We compared cardiovascular events between cohorts using cause\u2010specific Cox proportional hazards regression. The study included 5301 matched pairs in the analysis of major adverse cardiovascular events plus and 5564 in the analysis of arrhythmia. Cardiovascular events were more likely among patients with hyperkalemia relative to those without hyperkalemia, with the risk of major adverse cardiovascular events plus increased by 32% (23%\u201340%) and the risk of arrhythmia increased by 59% (44%\u201375%; both\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Among patients with CKD stages 3b\/4, patients with hyperkalemia experienced significantly higher risks of major adverse cardiovascular events and arrhythmia in hospital settings relative to patients without hyperkalemia.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.035256","type":"journal-article","created":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T03:56:31Z","timestamp":1735098991000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Hyperkalemia and the Risks of Adverse Cardiovascular Outcomes in Patients With Chronic Kidney Disease"],"prefix":"10.1161","volume":"14","author":[{"given":"Abiy","family":"Agiro","sequence":"first","affiliation":[{"name":"AstraZeneca Wilmington DE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Mu","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc. Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Cook","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc. Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8576-8614","authenticated-orcid":false,"given":"Alexandra","family":"Greatsinger","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc. New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0141-2241","authenticated-orcid":false,"given":"Jingyi","family":"Chen","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc. Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Zhao","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc. Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1231-2223","authenticated-orcid":false,"given":"Elaine","family":"Louden","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc. Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Colman","sequence":"additional","affiliation":[{"name":"AstraZeneca Wilmington DE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Desai","sequence":"additional","affiliation":[{"name":"AstraZeneca Wilmington DE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7599-0534","authenticated-orcid":false,"given":"Glenn M.","family":"Chertow","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfx312"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab159"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2017.06.002"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-021-01555-5"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01730215"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocpiqo.2020.10.001"},{"key":"e_1_3_2_8_2","first-page":"s307","article-title":"The burden of hyperkalemia in patients with cardiovascular and renal disease","volume":"21","author":"Dunn JD","year":"2015","unstructured":"Dunn JD, Benton WW, Orozco\u2010Torrentera E, Adamson RT. The burden of hyperkalemia in patients with cardiovascular and renal disease. Am J Manag Care. 2015;21:s307\u2013s315.","journal-title":"Am J Manag Care"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.07.067"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.07821109"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.132"},{"key":"e_1_3_2_12_2","first-page":"1","article-title":"KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"3","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group","year":"2013","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group . KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3:1\u2013150.","journal-title":"Kidney Int Suppl"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/26335565221098832"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181a663cc"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1214\/aoap\/1177005436"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5232"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt212"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2021.02.038"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1159\/000479802"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05850809"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy100"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-41-1-153"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfz206"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2009.04.041"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.10.011"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-017-6767-5"},{"key":"e_1_3_2_27_2","first-page":"S212","article-title":"Evaluation of the treatment gap between clinical guidelines and the utilization of renin\u2010angiotensin\u2010aldosterone system inhibitors","volume":"21","author":"Epstein M","year":"2015","unstructured":"Epstein M, Reaven NL, Funk SE, McGaughey KJ, Oestreicher N, Knispel J. Evaluation of the treatment gap between clinical guidelines and the utilization of renin\u2010angiotensin\u2010aldosterone system inhibitors. Am J Manag Care. 2015;21:S212\u2013S220.","journal-title":"Am J Manag Care"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-022-03054-5"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-023-02518-w"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.12651018"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.124.035256","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T10:55:35Z","timestamp":1740480935000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.124.035256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,7]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1,7]]}},"alternative-id":["10.1161\/JAHA.124.035256"],"URL":"https:\/\/doi.org\/10.1161\/jaha.124.035256","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,7]]},"assertion":[{"value":"2024-02-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e035256"}}