Serum potassium dynamics during acute heart failure hospitalization
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ORIGINAL PAPER
Serum potassium dynamics during acute heart failure hospitalization Pedro Caravaca Perez1,2 · José R. González‑Juanatey1,3 · Jorge Nuche1,4 · Laura Morán Fernández1,2 · David Lora Pablos5 · Jesús Alvarez‑García1,6 · Ramón Bascompte Claret7 · Manuel Martínez Selles1,8 · Rafael Vázquez García9 · Luis Martínez Dolz1,10 · Marta Cobo‑Marcos1,11 · Domingo Pascual Figal1,12 · Maria G. Crespo‑Leiro1,13 · Julio Nuñez Villota1,14 · Juan Cinca Cuscullola4 · Juan F. Delgado1,2,15 Received: 1 August 2020 / Accepted: 30 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Available information about prognostic implications of potassium levels alteration in the setting of acute heart failure (AHF) is scarce. Objectives We aim to describe the prevalence of dyskalemia (hypo or hyperkalemia), its dynamic changes during AHFhospitalization, and its long-term clinical impact after hospitalization. Methods We analyzed 1779 patients hospitalized with AHF who were included in the REDINSCOR II registry. Patients were classified in three groups, according to potassium levels both on admission and discharge: hypokalemia (potassium 5 mEq/L). Results The prevalence of hypokalemia and hyperkalemia on admission was 8.2 and 4.6%, respectively, and 6.4 and 2.7% at discharge. Hyperkalemia on admission was associated with higher in-hospital mortality (OR = 2.32 [95% CI: 1.04–5.21] p = 0.045). Among patients with hypokalemia on admission, 79% had normalized potassium levels at discharge. In the case of patients with hyperkalemia on admission, 89% normalized kalemia before discharge. In multivariate Cox regression, dyskalemia was associated with higher 12-month mortality, (HR = 1.48 [95% CI, 1.12–1.96], p = 0.005). Among all patterns of dyskalemia persistent hypokalemia (HR = 3.17 [95% CI: 1.71–5.88]; p
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