Determinants of Mortality of Patients with Extreme Hyperkalemia

Background: Hyperkalemia is a life-threatening condition, mortality can develop if delay medical treatment. We therefore like to analyze the result of these patients and see the determinant(s) of mortality, to see if there is a better way to provide better therapy. Methods: We analyzed the patients who were sent to our emergent room between January, first, 2000 and July 10th , 2000 with extremely high serum potassium (＞6.0meq/L) level and recorded their clinical presentation, comorbid medical conditions, previous medication history, the initial BUN, Cr and potassium level, the ways of medical treatment and their outcome. Results: There are total 80 patients were included in this study. There were 37 female and 43 male with a mean age of 64.74 ± 15.24 years. The overall hospital mortality rate was 18.8% (15 over 80) during that admission. Almost all patients received hemodialysis therapy within 3 hours. There were no significant differences between survivors and non-survivors in terms of age, gender, medical medical history. Serum BUN and potassium level are the same. But lower serum creatinine level and a positive history of hypertension and chronic renal insufficiency seem to be more among whom survive. Using binary logistic regression model, we further analyzed all possible variables and the result and found only serum creatinine level influence the patient mortality. Conclusion: Extreme hyperkalemia is a common medical emergency, and the treatment becomes standardized in most medical center. Most patients received similar therapy, but the mortality rate remains to be high even with prompt hemodialysis. When happen in patients without a history of chronic renal failure, it often indicates a more severe underlying medical illness and often carry an even higher mortality