A new study published in The American Journal of Emergency Medicine foundf that rapid correction of elevated serum potassium levels was associated with significant reduced mortality in patients admitted to the emergency department (ED) for hyperkalemia.

Hyperkalemia describes a higher than normal potassium level in the blood. Whereas normal potassium levels are between 3.6 and 5.2 millimoles per liter, a level higher than 6.0 can be dangerous and requires immediate treatment.2 The most common causes are acute kidney failure and chronic kidney disease, although other causes include Addison's disease and dehydration.2

In the study, researchers used electronic medical records of ED patients with hyperkalemia between October 2016 and October 2017.1 In the study, hyperkalemia was defined as a blood potassium level greater than or equal to 5.5 milliequivalents per liter. The main outcome was in-hospital mortality.1

Of 114,977 ED visits in the time frame being studied, 1033 (0.9%) had hyperkalemia. The patients' mean age was 60 years and 58% were male. Of those, 884 had a second potassium measurements within 5 hours.1

The researchers found that mortality and admission rates were higher in patients with hyperkalemia than in those with normal potassium levels (8.5% vs. 0.8%, respectively). Mortality rates were lower in patients whose potassium levels normalized compared with those whose levels remained elevated (6.3% vs. 12.7%, respectively).1

After adjusting for age, creatinine, comorbidities, and initial potassium levels, the normalization of potassium was associated with a 50% reduction in mortality rates. Based on these findings, the researchers concluded that efforts to rapidly identify and treat hyperkalemia in the ED setting are needed.1

REFERENCES
1. Singer A, Thode H, Peacock W. Rapid correction of hyperkalemia is associated with reduced mortality in ED patients. The American Journal of Emergency Medicine, Dec 10, 2019. Accessed Jan 9, 2020.
2. High Potassium (Hyperkalemia). Mayo Clinic Website, https://www.mayoclinic.org/symptoms/hyperkalemia/basics/causes/sym-200540776. Accessed Jan 9, 2020.