Frequency of Hyperkalemia in Patients Presenting with Heart Failure with Reduced Ejection Fraction at Tertiary Care Hospital Karachi

Background: Hyperkalemia, characterized by elevated serum potassium levels greater than 5.0 mmol/L, poses significant risks for patients due to its potential to induce cardiac arrhythmias and conduction abnormalities. This condition is particularly prevalent among patients with chronic conditions such as kidney disease, heart failure (HF), and diabetes, especially those treated with renin-angiotensin-aldosterone system inhibitors (RAASi). While these medications are beneficial for heart failure management, they can exacerbate renal dysfunction and hyperkalemia, both associated with poor clinical outcomes. Objective: The study aimed to determine the frequency of hyperkalemia among patients presenting with chronic heart failure with reduced ejection fraction (HFrEF) at a tertiary care facility in Karachi. Methods: A cross-sectional study was conducted at the Department of Adult Cardiology, National Institute of Cardiovascular Diseases (NICVD), Karachi, from August 22, 2020, to February 21, 2021. The study enrolled 139 patients aged between 20 and 70 years diagnosed with HFrEF based on echocardiography findings. Informed consent was obtained from all participants. Comprehensive clinical evaluations and laboratory measurements of serum potassium were performed to identify hyperkalemia. Data collection included demographic information, clinical history, comorbid conditions, and serum potassium levels. The data were analyzed using SPSS Version 25, with descriptive statistics summarizing demographic characteristics and chi-square tests assessing the relationships between hyperkalemia and patient characteristics. Results: The mean age of the study cohort was 58.4 ± 15.9 years, with a male predominance of 55.4%. Dyslipidemia was observed in 30.2% of the participants. Hyperkalemia was found in 39.6% of the patients. The analysis showed no significant correlation between hyperkalemia and gender (p=0.991), hypertension (p=0.948), dyslipidemia (p=0.098), monthly income (p=0.770), or smoking status (p=0.853). Conclusion: Hyperkalemia is significantly prevalent in patients with chronic heart failure and reduced ejection fraction. Routine screening and management of serum potassium levels are crucial in this patient population to mitigate the risks associated with hyperkalemia and optimize heart failure management.