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Hyperkalaemia in people with diabetes: occurrence, risk factors and outcomes in a Danish population-based cohort study.
- Source :
-
Diabetic Medicine . Aug2018, Vol. 35 Issue 8, p1051-1060. 10p. - Publication Year :
- 2018
-
Abstract
- Aims To examine the incidence, risk factors and clinical outcomes of hyperkalaemia in people with diabetes in a realworld setting. Methods Using Danish health registries, we identified a population-based cohort of people with first-time drug-treated diabetes, in the period 2000-2012. First, the cumulative incidence of hyperkalaemia, defined as first blood test with potassium level >5.0 mmol/l after diabetes treatment initiation, was ascertained. Second, in a case-control analysis, risk factors were compared in people with vs without hyperkalaemia. Third, clinical outcomes were assessed among individuals with hyperkalaemia in a before-after analysis, and among people with and without hyperkalaemia in a matched cohort analysis. Results Of 68 601 individuals with diabetes (median age 62 years, 47% women), 16% experienced hyperkalaemia (incidence rate 40 per 1000 person-years) during a mean follow-up of 4.1 years. People who developed hyperkalaemia had a higher prevalence of chronic kidney disease [prevalence ratio 1.74 (95% CI 1.68-1.81)], heart failure [prevalence ratio 2.35 (95% CI 2.18-2.54)], use of angiotensin-converting enzyme inhibitors [prevalence ratio 1.24 (95% CI 1.20-1.28)], use of spironolactone [prevalence ratio 2.68 (95% CI 2.48-2.88)] and potassium supplements [prevalence ratio 1.59 (95% CI 1.52-1.67)]. In people with diabetes who developed hyperkalaemia, 31% were acutely hospitalized within 6 months before hyperkalaemia, increasing to 50% 6 months after hyperkalaemia [before-after risk ratio 1.67 (95% CI 1.61-1.72)]. The 6-month mortality rate after hyperkalaemia was 20%. Compared with matched individuals without hyperkalaemia, the hazard ratio for death was 6.47 (95% CI 5.81-7.21). Conclusions One in six newly diagnosed people with diabetes experienced a hyperkalaemic event, which was associated with severe clinical outcomes and death. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ACE inhibitors
*DIABETES complications
*DIAGNOSIS of diabetes
*SPIRONOLACTONE
*BLOOD testing
*CHRONIC kidney failure
*CONFIDENCE intervals
*DIABETES
*DIETARY supplements
*HEART failure
*LONGITUDINAL method
*POTASSIUM
*TREATMENT effectiveness
*DISEASE incidence
*DISEASE prevalence
*CASE-control method
*HYPERKALEMIA
*ODDS ratio
*DISEASE risk factors
*THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 07423071
- Volume :
- 35
- Issue :
- 8
- Database :
- Academic Search Index
- Journal :
- Diabetic Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 131060804
- Full Text :
- https://doi.org/10.1111/dme.13687