Year: 2020
Type: review
Abstract: Potassium (K + ) is the most abundant cation in humans and is essential for normal cellular function. Alterations in K + regulation can lead to neuromuscular, gastrointestinal, and cardiac abnormalities. Dyskalemia (i.e., hypokalemia and hyperkalemia) in heart failure is common because of heart failure itself, related comorbidities, and medications. Dyskalemia has important prognostic implications. Hypokalemia is associated with excess morbidity and mortality in heart failure. The lower the K + levels, the higher the risk, starting at K + levels below approximately 4.0 mmol/l, with a steep risk increment with K + levels <3.5 mmol/l. Hyperkalemia (>5.5 mmol/l) has also been associated with increased risk of adverse events; however, this association is prone to reverse-causation bias as stopping renin angiotensin aldosterone system inhibitor therapy in the advent of hyperkalemia likely contributes the observed risk. In this state-of-the-art review, practical and easy-to-implement strategies to deal with both hypokalemia and hyperkalemia are provided as well as guidance for the use of potassium-binders.
Institutions: Inserm, Université de Lorraine, University of Mississippi Medical Center, University of Mississippi, University of Michigan, Michigan Medicine, Berlin-Brandenburger Centrum für Regenerative Therapien, German Centre for Cardiovascular Research, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charité – Universitätsmedizin Berlin, The George Institute for Global Health, UNSW Sydney, The George Institute for Global Health, Saint Luke's Hospital, University of Missouri–Kansas City, Karolinska University Hospital, Karolinska Institutet, American Heart Association, University of Chicago, University of Maryland, Baltimore
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,000
OpenAlex ID: W3032629802