Hyperkalaemia-related reduction of RAASi treatment associates with more subsequent inpatient care.
Nephrol Dial Transplant
; 39(8): 1258-1267, 2024 Jul 31.
Article
de En
| MEDLINE
| ID: mdl-38253386
ABSTRACT
BACKGROUND:
Hyperkalaemia is a barrier to achieving optimal, guideline-directed treatment with renin-angiotensin-aldosterone system inhibitors (RAASis) in patients with chronic kidney disease (CKD) and/or heart failure (HF). This study describes the association between hyperkalaemia-related RAASi treatment reduction and the number of hospitalized days in patients with CKD and/or HF in Sweden and Japan.METHODS:
Using data from health registers and hospital medical records, patients with CKD and/or HF currently receiving RAASis who experienced an index hyperkalaemia episode were identified and categorized as having maintained or reduced RAASi treatment post-index; propensity score matching (11) was applied to balance the groups in terms of baseline characteristics. Changes in the number of all-cause, CKD- and HF-related hospitalized days per patient-year during 6 months pre- versus post-index and the number of days alive and out of hospital (DAOH) during 6 months post-index were described.RESULTS:
Overall, 20 824 and 7789 patients were included from Sweden and Japan, respectively, 42% and 38% of whom reduced their RAASi treatment after the index hyperkalaemia episode. During the 6 months post-index, all-cause hospitalization increased by 18.2 days [95% confidence interval (CI) 17.0-19.2] per person-year in Sweden and 17.9 days (95% CI 17.4-18.5) per person-year in Japan among patients with reduced RAASi treatment compared with increases of 9.4 days (95% CI 8.6-10.4) and 8.5 days (95% CI 8.0-9.0) per person-year, respectively, among patients with maintained RAASi treatment. The mean DAOH was 121.5 [standard deviation (SD) 75.0] in Sweden and 141.7 (SD 54.5) in Japan among patients with reduced RAASi treatment compared with 154.0 (SD 51.3) and 157.5 (SD 31.6), respectively, among patients with maintained RAASi treatment.CONCLUSION:
Patients whose RAASi treatment was reduced after a hyperkalaemia episode had more hospitalized days and fewer DAOH compared with patients whose RAASi treatment was maintained.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Défaillance cardiaque
/
Hospitalisation
/
Hyperkaliémie
Type d'étude:
Guideline
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Pays/Région comme sujet:
Asia
/
Europa
Langue:
En
Journal:
Nephrol Dial Transplant
Sujet du journal:
NEFROLOGIA
/
TRANSPLANTE
Année:
2024
Type de document:
Article
Pays d'affiliation:
Suède
Pays de publication:
Royaume-Uni