The prevalence of hyperkalemia in the United States

Abstract

Objective: The retrospective study aimed to estimate prevalence of hyperkalemia using a large US commercial claims database.

Methods: Adults with serum potassium lab data (2010 to 2014) and ≥1 calendar year of data were included from a large US commercial claims database. Hyperkalemia was defined as ≥2 serum potassium measurements >5.0 mEq/L or one hyperkalemia diagnosis code (ICD-9-CM, 276.7) or one sodium polystyrene sulfonate fill. Hyperkalemia prevalence was estimated for the overall population and subgroups with hyperkalemia-related comorbidities by calendar year. Hyperkalemia prevalence was also standardized to the US population to estimate the number of US adults with hyperkalemia.

Results: The analysis included 2,270,635 patients (2010–2014). The annual prevalence of hyperkalemia in the overall population was 1.57% in 2014, with higher rates observed in patients with chronic kidney disease (CKD), heart failure, diabetes and hypertension. Among patients with CKD and/or heart failure, the 2014 annual prevalence was 6.35%. Among patients with hyperkalemia, 48.43% had CKD and/or heart failure in 2014. The prevalence of hyperkalemia was higher in patients with more severe CKD, as well as older patients and men. Extrapolating those results to the US population supports that 1.55% or 3.7 million US adults had hyperkalemia in 2014.

Conclusions: An estimated 3.7 million US adults had hyperkalemia in 2014, and this prevalence rate has increased since 2010. In patients with CKD and/or heart failure, the annual prevalence of hyperkalemia was 6.35% in 2014, and about half of all patients with hyperkalemia have either CKD and/or heart failure.

Keywords:

• Hyperkalemia
• prevalence
• chronic kidney disease
• heart failure

Transparency

Declaration of funding

Funding for this research was provided by ZS Pharma, a member of the AstraZeneca Group.

Author contributions: Data was analyzed by Analysis Group and interpreted in collaboration with all other authors. The study sponsor was involved in all stages of the study research and manuscript preparation, but all authors participated in the design of the study and contributed to the manuscript development. All the authors vouch for the accuracy and completeness of the data reported and the adherence of the study to the protocol, and all the authors made the decision to submit the manuscript for publication.

Declaration of financial/other relationships

J.M.W. has disclosed that he is an employee of ZS Pharma, a member of the AstraZeneca Group. K.A.B., F.M., E.M., W.T. and E.Q.W. have disclosed that they are employees of Analysis Group Inc., which has received consultancy fees from ZS Pharma, a member of the AstraZeneca Group.

CMRO peer reviewers on this manuscript declare consultancy and stock options for the potassium lowering drug, Patiromer, and declare being members of an advisory board for AstraZeneca.