Incidence and Clinical Significance of Hyperkalemia Following Heart Transplantation
Copyright © 2020 Elsevier Inc. All rights reserved..
BACKGROUND: Hyperkalemia (HK) is a life-threatening complication following solid organ transplantation, and patients often need potassium-chelating agents and deviations from standard posttransplant protocols. This is the first study to report the incidence and clinical impact of hyperkalemia following heart transplantation.
METHODS: We retrospectively included patients who underwent heart transplantation at our institution between April 2014 and December 2018. Patients with multiorgan transplantation were excluded. Clinical outcomes of patients who had serum potassium >5.5 mEq/L in the first year posttransplant (HK group) were compared to patients who did not have serum potassium >5.5 mEq/L in the first year posttransplant (non-HK group).
RESULTS: A total of 143 patients were included in this study. During the first year posttransplant, cumulative incidence of serum potassium >5.0, >5.5, and >6.0 mEq/L was 96%, 63%, and 24%, respectively. Fifty-five percent of patients required treatment with potassium-chelating agents. Sulfamethoxazole-trimethoprim was discontinued because of HK in 39% of patients. Overall survival of patients in the HK group (n = 89) was comparable to that of patients in the non-HK group (n = 54, 91% vs 98% at 1 year, P = .19), whereas infection-free survival was significantly lower in the HK group (34% vs 53% at 1 year, P = .010). Multivariate analysis revealed pretransplant renal dysfunction (odds ratio = 2.62; 95% confidence interval, 1.18-5.80; P = .018) and use of mechanical circulatory support (odds ratio = 2.90; 95% confidence interval, 1.08-7.76; P = .035) as significant predictors of posttransplant hyperkalemia.
CONCLUSIONS: The incidence of HK following heart transplantation was high, with more than half of patients requiring any therapeutic interventions, and HK was related to an increase in infection events.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:53 |
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| Enthalten in: |
Transplantation proceedings - 53(2021), 2 vom: 22. März, Seite 673-680 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Uriel, Matan [VerfasserIn] |
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| Anmerkungen: |
Date Completed 24.05.2021 Date Revised 24.05.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.transproceed.2020.11.002 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM319227537 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Hyperkalemia (HK) is a life-threatening complication following solid organ transplantation, and patients often need potassium-chelating agents and deviations from standard posttransplant protocols. This is the first study to report the incidence and clinical impact of hyperkalemia following heart transplantation | ||
| 520 | |a METHODS: We retrospectively included patients who underwent heart transplantation at our institution between April 2014 and December 2018. Patients with multiorgan transplantation were excluded. Clinical outcomes of patients who had serum potassium >5.5 mEq/L in the first year posttransplant (HK group) were compared to patients who did not have serum potassium >5.5 mEq/L in the first year posttransplant (non-HK group) | ||
| 520 | |a RESULTS: A total of 143 patients were included in this study. During the first year posttransplant, cumulative incidence of serum potassium >5.0, >5.5, and >6.0 mEq/L was 96%, 63%, and 24%, respectively. Fifty-five percent of patients required treatment with potassium-chelating agents. Sulfamethoxazole-trimethoprim was discontinued because of HK in 39% of patients. Overall survival of patients in the HK group (n = 89) was comparable to that of patients in the non-HK group (n = 54, 91% vs 98% at 1 year, P = .19), whereas infection-free survival was significantly lower in the HK group (34% vs 53% at 1 year, P = .010). Multivariate analysis revealed pretransplant renal dysfunction (odds ratio = 2.62; 95% confidence interval, 1.18-5.80; P = .018) and use of mechanical circulatory support (odds ratio = 2.90; 95% confidence interval, 1.08-7.76; P = .035) as significant predictors of posttransplant hyperkalemia | ||
| 520 | |a CONCLUSIONS: The incidence of HK following heart transplantation was high, with more than half of patients requiring any therapeutic interventions, and HK was related to an increase in infection events | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Nguyen, Ann |e verfasserin |4 aut | |
| 700 | 1 | |a Imamura, Teruhiko |e verfasserin |4 aut | |
| 700 | 1 | |a Lourenco, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Rodgers, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Raikhelkar, Jayant |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Gene |e verfasserin |4 aut | |
| 700 | 1 | |a Sayer, Gabriel |e verfasserin |4 aut | |
| 700 | 1 | |a Uriel, Nir |e verfasserin |4 aut | |
| 700 | 1 | |a Fujino, Takeo |e verfasserin |4 aut | |
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