Heart failure (HF) patients are particularly susceptible to electrolyte abnormalities and especially to hyperkalemia. Potassium (K) balance may be lost botht hrough the neurohormonal mechanisms and through the drugs used in the treatment of this illness.

Both hypokalaemia and hyperkalaemia are associated with increased mortality, mainly due to a higher risk of potentially fatal arrhythmia.

The aim of this study was to explore the incidence and predictors of hyperkalemia in a broad population of heart failure patients

This was a retrospective study of 1614 consecutive patients admitted to the therapeutic unit for HF between May 2006 and September 2014. Patients on dialysis and those with an estimated glomular filtration rate (GFR) <10ml/min/ 1,73m2 were excluded. Complete history on admission, age, sex, body weight, physical findings, comorbidities, and laboratory information were collected.

The mean age of our population was 68.3 years, with a male predominance (62.6%). In 20 patients (1.2%) K was<3.0mmol/L, and in 392patients (24.2%) K was>5.0mmol/L. Independent of treatment assignment, patients at highest risk for hyperkalemia were those with age ≥75 years (58%), diabetes (51.9%), male gender (66.5%), high potassium at baseline (70.5%), renal dysfunction (49.9%), and those receiving therapy with angiotensin-converting enzyme (ACE) inhibitors (55.3%) or spironolactone (57.2%).

Changes in potassium ion may cause life-threatening arrhythmias. The risk of hyperkalemia is increased in symptomatic HF patients with comorbidities or combined renin-angiotensin-aldosterone system (RAAS) blockade.

The author hereby declares no conflict of interest