Gülsüm Meral YILMAZ ÖZTEKİN, Ahmet GENÇ, Anıl ŞAHİN, Göksel ÇAĞIRCI, Şakir ARSLAN

Kalp yetmezliği polikliniğinde hiperkaleminin sıklığı ve öngördürücüleri

Amaç: Hiperkalemi, kalp yetmezliğinde (KY) yaygın ve potansiyel olarak yaşamı tehdit eden bir sorundur. Bu çalışmada KY polikliniğinde hiperkalemi sıklığı ve ilişkili faktörlerin gerçek yaşam verileriyle gösterilmesi amaçlanmıştır.Yöntemler: KY polikliniğinde izlenen sol ventrikül ejeksiyon fraksiyonu ≤ %40 ve potasyum düzeyi ≥ 3.5 mmol/L olan 1146 hasta çalışmaya dahil edildi.Bulgular: Hastaların medyan potasyum değeri 4.6 mmol/L [IQR, 4.3-5] idi. Başlangıç potasyum düzeylerine göre 3.5-5 mmol/L (normokalemi), 5.1-5.5 mmol/L (hafif hiperkalemi) ve ≥ 5.5 mmol/L (orta-ciddi hiperkalemi) olmak üzere üç grupta değerlendirildi. %14.5'inde hafif hiperkalemi ve %7.1'inde orta ila şiddetli hiperkalemi mevcuttu. Hastaların %21.6'sında potasyum değeri > 5 mmol/L idi. Tahmini glomerüler filtrasyon hızı (eGFR) (OR: 0.969, 95% CI: 0.961-0.976, p<0.001), anjiyotensin dönüştürücü enzim inhibitörü/anjiyotensin reseptör blokeri (ACE-I/ARB) (OR: 1.697, 95% CI: 1.124-2.562, p=0.012) ve mineralokortikoid reseptör antagonistleri (MRA) (OR: 1.511, 95% CI: 1.066-2.142, p=0.02) hiperkalemi için bağımsız faktörler olarak saptandı.Sonuç: eGFR düzeyi, ACE-I/ARB ve MRA gerçek yaşam verilerinde kronik KY'de hiperkalemi ile ilişkili saptandı.

Anahtar Kelimeler:

Hiperkalemi, Kalp yetmezliği, Potasyum, Renin-Anjiyotensin Sistemi.

Frequency and predictors of hyperkalemia in the heart failure outpatient clinic

Aim: Hyperkalemia is a common and potentially life-threatening problem in heart failure (HF). In this study, we aimed to show the frequency of hyperkalemia and related factors in the HF outpatient clinic with real-life data.Methods: 1 146 patients monitored in the HF outpatient clinic with left ventricular ejection fraction ≤ 40% and potassium level ≥ 3.5 mmol/L were included.Results: The potassium value of the patients was median 4.6 mmol/L [IQR, 4.3-5]. It was evaluated in three groups as 3.5-5 mmol/L (normokalemia), 5.1-5.5 mmol/L (mild hyperkalemia) and ≥ 5.5 mmol/L (moderate to severe hyperkalemia), according to baseline potassium levels. Mild hyperkalemia was present in 14.5% and moderate to severe hyperkalemia was present in 7.1%. The potassium value was > 5 mmol/L in 21.6% of the patients. The estimated glomerular filtration rate (eGFR) (OR: 0.969, 95% CI: 0.961-0.976, p<0.001), angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACE-I/ARB) (OR: 1.697, 95% CI: 1.124-2.562, p=0.012), and mineralocorticoid receptor antagonists (MRA) (OR: 1.511, 95% CI: 1.066-2.142, p=0.02) were considered as independent factors for hyperkalemia.Conclusion: eGFR level, ACE-I/ARB, and MRA were associated with hyperkalemia in chronic HF in real-life data.

Keywords:

Heart Failure, Hyperkalemia, Potassium, Renin-Angiotensin System.,

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