{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:13:29Z","timestamp":1772165609008,"version":"3.50.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hyperkalaemia (HK) is a serious and potentially life-threatening condition. Both acute and chronic conditions may alter potassium homeostasis. Our aim is to describe HK incidence, clinical outcomes, and associated resource use within a large, integrated healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients seen at Intermountain Healthcare facilities with a serum potassium (sK) result between January 1, 2003 and December 31, 2018 were retrospectively studied. Descriptive assessment of a population with detected HK, defined by any sK\u2009&gt;\u20095.0\u00a0mmol\/L and HK frequency and severity to associated resource use and characteristics of HK predictors were made. Multivariable Cox hazard regression was used to evaluate HK to outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1,208,815 patients included, 13% had HK. Compared to no-HK, HK patients were older (60\u2009\u00b1\u200918 vs 43\u2009\u00b1\u200918\u00a0years,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), male (51% vs 41%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), and had greater disease burden (Charlson Comorbidity Index 3.5\u2009\u00b1\u20092.8 vs 1.7\u2009\u00b1\u20091.4,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). At 3\u00a0years, more HK patients experienced major adverse cardiovascular events (MACEs) (19 vs 3%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), persisting post-adjustment (multivariable hazard ratio\u2009=\u20091.60,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). They incurred higher costs for emergency department services ($552\u2009\u00b1\u20097,574 vs $207\u2009\u00b1\u20091,930,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and inpatient stays ($10,956\u2009\u00b1\u200993,026 vs $1,477\u2009\u00b1\u200921,423,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). HyperK Risk Scores for the derivation and validation cohorts were: 44% low-risk, 45% moderate-risk, 11% high-risk. Strongest HK predictors were renal failure, dialysis, aldosterone blockers, diabetes, and smoking.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Within this large system, HK was associated with a large clinical burden, affecting over 1 in 10 patients; HK was also associated with increased 3-year MACE risk and higher medical costs. Although risk worsened with more severe or persistently recurring HK, even mild or intermittent HK episodes were associated with significantly greater adverse clinical outcomes and medical costs. The HyperK Score predicted patients who may benefit from closer management to reduce HK risk and associated costs. It should be remembered that our assumptions are valid only for detected HK and not HK per se.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12875-022-01667-1","type":"journal-article","created":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T06:40:02Z","timestamp":1648795202000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Real-world clinical burden and economic assessment associated with hyperkalaemia in a large integrated healthcare system: a retrospective analysis"],"prefix":"10.1186","volume":"23","author":[{"given":"Joseph B.","family":"Muhlestein","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Kammerer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tami L.","family":"Bair","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirk U.","family":"Knowlton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viet T.","family":"Le","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey L.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald L.","family":"Lapp\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi T.","family":"May","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,4,1]]},"reference":[{"key":"1667_CR1","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1016\/j.amjmed.2015.05.040","volume":"128","author":"CP Kovesdy","year":"2015","unstructured":"Kovesdy CP. 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The Intermountain Healthcare Privacy Board granted a waiver of informed consent prior to study initiation. Our investigation conforms with the principles outlined in the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Joseph B. Muhlestein, Tami L. Bair, Kirk K. Knowlton, Viet T. Le, Jeffrey L. Anderson, Donald L. Lapp\u00e9, and Heidi T. May report employment by Intermountain Healthcare, which conducted research funded by Vifor Pharma, Inc.Jennifer Kammerer reports employment by and stock in Vifor Pharma, Inc.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"65"}}