BACKGROUND: Hyperkalemia (serum potassium >5.0 mEq/L) may be caused by reduced kidney function and drugs affecting the renin-angiotensin-aldosterone system and is often present in patients with chronic kidney disease (CKD). OBJECTIVE: To quantify the burden of hyperkalemia in US Medicare fee-for-service and commercially insured populations using real-world claims data, focusing on prevalence, comorbidities, mortality, medical utilization, and cost. METHODS: A descriptive, retrospective claims data analysis was performed on patients with hyperkalemia using the 2014 Medicare 5% sample and the 2014 Truven Health Analytics MarketScan Commercial Claims and Encounter databases. The starting study samples required patient insurance eligibility during ≥1 months in 2014. The identification of hyperkalemia and other comorbidities required having ≥1 qualifying claims in 2014 with an appropriate International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code in any position. To address the differences between patients with and without hyperkalemia, CKD subsamples were analyzed separately. Mortality rates were calculated in the Medicare sample population only. The claims were grouped into major service categories; the allowed costs reflected all costs incurred by each cohort divided by the total number of member months for that cohort. RESULTS: The prevalence of hyperkalemia in the Medicare and commercially insured samples was 2.3% and 0.09%, respectively. Hyperkalemia was associated with multiple comorbidities, most notably CKD. The prevalence of CKD in the Medicare and the commercially insured members with hyperkalemia was 64.8% and 31.8%, respectively. After adjusting for CKD severity, the annual mortality rate for Medicare patients with CKD and hyperkalemia was 24.9% versus 10.4% in patients with CKD without hyperkalemia. The allowed costs in patients with CKD and hyperkalemia in the Medicare and commercially insured cohorts were more than twice those in patients with CKD without hyperkalemia. Inpatient care accounted for >50% of costs in patients with CKD and hyperkalemia. CONCLUSION: Hyperkalemia is associated with substantial clinical and economic burden among US commercially insured and Medicare populations.
BACKGROUND:Hyperkalemia (serum potassium >5.0 mEq/L) may be caused by reduced kidney function and drugs affecting the renin-angiotensin-aldosterone system and is often present in patients with chronic kidney disease (CKD). OBJECTIVE: To quantify the burden of hyperkalemia in US Medicare fee-for-service and commercially insured populations using real-world claims data, focusing on prevalence, comorbidities, mortality, medical utilization, and cost. METHODS: A descriptive, retrospective claims data analysis was performed on patients with hyperkalemia using the 2014 Medicare 5% sample and the 2014 Truven Health Analytics MarketScan Commercial Claims and Encounter databases. The starting study samples required patient insurance eligibility during ≥1 months in 2014. The identification of hyperkalemia and other comorbidities required having ≥1 qualifying claims in 2014 with an appropriate International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code in any position. To address the differences between patients with and without hyperkalemia, CKD subsamples were analyzed separately. Mortality rates were calculated in the Medicare sample population only. The claims were grouped into major service categories; the allowed costs reflected all costs incurred by each cohort divided by the total number of member months for that cohort. RESULTS: The prevalence of hyperkalemia in the Medicare and commercially insured samples was 2.3% and 0.09%, respectively. Hyperkalemia was associated with multiple comorbidities, most notably CKD. The prevalence of CKD in the Medicare and the commercially insured members with hyperkalemia was 64.8% and 31.8%, respectively. After adjusting for CKD severity, the annual mortality rate for Medicare patients with CKD and hyperkalemia was 24.9% versus 10.4% in patients with CKD without hyperkalemia. The allowed costs in patients with CKD and hyperkalemia in the Medicare and commercially insured cohorts were more than twice those in patients with CKD without hyperkalemia. Inpatient care accounted for >50% of costs in patients with CKD and hyperkalemia. CONCLUSION:Hyperkalemia is associated with substantial clinical and economic burden among US commercially insured and Medicare populations.
Authors: Olivier Moranne; Marc Froissart; Jerome Rossert; Cedric Gauci; Jean-Jacques Boffa; Jean Philippe Haymann; Mona Ben M'rad; Christian Jacquot; Pascal Houillier; Benedicte Stengel; Bruno Fouqueray Journal: J Am Soc Nephrol Date: 2008-11-12 Impact factor: 10.121
Authors: David N Juurlink; Muhammad M Mamdani; Douglas S Lee; Alexander Kopp; Peter C Austin; Andreas Laupacis; Donald A Redelmeier Journal: N Engl J Med Date: 2004-08-05 Impact factor: 91.245
Authors: Zubaid Rafique; Matthew R Weir; Macaulay Onuigbo; Bertram Pitt; Richard Lafayette; Javed Butler; Maria Lopes; Carolyn Farnum; W Frank Peacock Journal: J Manag Care Spec Pharm Date: 2017-04
Authors: Conner D Galloway; Alexander V Valys; Jacqueline B Shreibati; Daniel L Treiman; Frank L Petterson; Vivek P Gundotra; David E Albert; Zachi I Attia; Rickey E Carter; Samuel J Asirvatham; Michael J Ackerman; Peter A Noseworthy; John J Dillon; Paul A Friedman Journal: JAMA Cardiol Date: 2019-05-01 Impact factor: 14.676