{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T15:41:11Z","timestamp":1793374871148,"version":"4.5.0"},"reference-count":55,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AstraZeneca","award":["4390\/016"],"award-info":[{"award-number":["4390\/016"]}]},{"award":["4390\/016"],"award-info":[{"award-number":["4390\/016"]}],"id":[{"id":"https:\/\/ror.org\/018nw3344","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["PI22\/00469"],"award-info":[{"award-number":["PI22\/00469"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["PI22\/00050"],"award-info":[{"award-number":["PI22\/00050"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["PI21\/00251"],"award-info":[{"award-number":["PI21\/00251"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["PI24\/00079"],"award-info":[{"award-number":["PI24\/00079"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["ERA-PerMed-JTC2022"],"award-info":[{"award-number":["ERA-PerMed-JTC2022"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["SPAREKID AC22\/00027"],"award-info":[{"award-number":["SPAREKID AC22\/00027"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"name":"RICORS program to RICORS2040-renal","award":["RD21\/0005\/0001"],"award-info":[{"award-number":["RD21\/0005\/0001"]}]},{"name":"RICORS program to RICORS2040-renal","award":["RD24\/0004\/0001"],"award-info":[{"award-number":["RD24\/0004\/0001"]}]},{"name":"European Union and SPACKDc","award":["PMP21\/00109"],"award-info":[{"award-number":["PMP21\/00109"]}]},{"name":"PREVENTCKD Consortium Project","award":["101101220"],"award-info":[{"award-number":["101101220"]}]},{"name":"KitNewCare Project","award":["101137054"],"award-info":[{"award-number":["101137054"]}]},{"name":"Programme HORIZON, DG\/Agency HADEA","award":["101168626 HORIZON-MSCA-2023-DN-01-01"],"award-info":[{"award-number":["101168626 HORIZON-MSCA-2023-DN-01-01"]}]},{"DOI":"10.13039\/501100004837","name":"MICINN","doi-asserted-by":"crossref","award":["RYC2018-024461-I"],"award-info":[{"award-number":["RYC2018-024461-I"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"crossref"}]},{"award":["RYC2018-024461-I"],"award-info":[{"award-number":["RYC2018-024461-I"]}],"id":[{"id":"https:\/\/ror.org\/05r0vyz12","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Hyperkalemia is common in patients with chronic kidney disease (CKD). However, its epidemiology may be evolving due to population aging, new therapeutic developments and novel estimated glomerular filtration rate (eGFR) equations. We have re-evaluated the epidemiology of hyperkalemia in a contemporary cohort in which eGFR was assessed using the EKFC equation recommended by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM). Methods: We analyzed 190,579 laboratory tests with serum potassium values corresponding to individual outpatients in Primary or Specialty Care from a single laboratory in 2023, representing 42% of the catchment area population. Results: Hypokalemia (&lt;3.5 mmol\/L) was present in 0.3% patients, hyperkalemia (\u22655.0 mmol\/L) in 10.5% (11.5% of men, 9.7% of women). Hyperkalemia was mostly mild (9.4%) but was severe in 0.1% overall and in 10.5% of CKD G5. One in four patients with hyperkalemia had CKD. Hyperkalemia was more common among patients with CKD G3\u2013G5 defined using the CKD-EPI2009 equation than defined using the EKFC equation (20.5 vs. 18.6%, p &lt; 0.0001). Using EKFC, hyperkalemia prevalence increased with decreasing eGFR from G1 (6.6%) to G2 (10.8%) and, especially in CKD G3\u2013G5 (G3 17.2% to G5 47.5%). In multivariate logistic analysis, worse renal function, worse diabetes control, older age, and surrogates for release of intracellular potassium during sample processing (red blood cell counts or size, platelet counts, elevated calcium levels) were independently associated with hyperkalemia. This multivariate model yielded an area under the curve (AUC) of the Receiver Operating Characteristic (ROC) curve for hyperkalemia of 0.678 (95% CI 0.674\u20130.682). Random forest also identified GFR as the most important feature associated with hyperkalemia and generally concurred with logistic analysis findings. Conclusions: Hyperkalemia remains common, especially in CKD G5. While hyperkalemia is mainly associated with low eGFR, sample processing should be optimized.<\/jats:p>","DOI":"10.3390\/diagnostics16091309","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T19:24:51Z","timestamp":1777317891000},"page":"1309","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence of Hyperkalemia in a Contemporary European Cohort According to EKFC eGFR Categories"],"prefix":"10.3390","volume":"16","author":[{"given":"Priscila","family":"Villalvazo","sequence":"first","affiliation":[{"name":"Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz, Universidad Aut\u00f3noma de Madrid, 28040 Madrid, Spain"},{"name":"Department of Medicine, Universidad Aut\u00f3noma de Madrid, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8036-9523","authenticated-orcid":false,"given":"Luis Miguel","family":"Molinero-Casares","sequence":"additional","affiliation":[{"name":"Alce Ingenier\u00eda, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7110-6409","authenticated-orcid":false,"given":"Maria Dolores","family":"Sanchez-Ni\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz, Universidad Aut\u00f3noma de Madrid, 28040 Madrid, Spain"},{"name":"Department of Medicine, Universidad Aut\u00f3noma de Madrid, 28029 Madrid, Spain"},{"name":"Department of Pharmacology, Universidad Aut\u00f3noma de Madrid, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9805-9523","authenticated-orcid":false,"given":"Alberto","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz, Universidad Aut\u00f3noma de Madrid, 28040 Madrid, Spain"},{"name":"Department of Medicine, Universidad Aut\u00f3noma de Madrid, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1016\/S0140-6736(18)31694-5","article-title":"Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: Reference and alternative scenarios for 2016\u20132040 for 195 countries and territories","volume":"392","author":"Foreman","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1016\/S0140-6736(24)00685-8","article-title":"Burden of disease scenarios for 204 countries and territories, 2022\u20132050: A forecasting analysis for the Global Burden of Disease Study 2021","volume":"403","author":"Vollset","year":"2024","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1093\/ckj\/sfz007","article-title":"Clarifying the concept of chronic kidney disease for non-nephrologists","volume":"12","author":"Bartsch","year":"2019","journal-title":"Clin. 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