Factors Associated with Hypokalemia after Furosemide Treatment in Hospitalized Patients with Acute Decompensated Heart Failure
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Abstract
Background: Hypokalemia, defined as serum potassium <3.5 mmol/L, is commonly associated with the use of loop diuretics. Hypokalemia after furosemide treatment may lead to adverse outcomes in hospitalized patients with acute decompensated heart failure (ADHF). Risk factors associated with hypokalemia in this patient population are not well characterized. This retrospective case-control study aimed to identify risk factors and outcomes associated with hypokalemia after furosemide treatment in hospitalized patients with ADHF.
Methods: The data were retrieved from the medical records using ICD-10 coding. Factors associated with hypokalemia were analyzed using univariate and multivariate logistic regression analyses. Clinical outcomes associated with the hypokalemia were also examined.
Results: A total of 350 patients met the eligibility criteria, of whom 101 patients developed hypokalemia after receiving furosemide, while 249 patients did not. Furosemide dose >1.5 mg/kg, urine volume after furosemide treatment >2 ml/kg/hour, higher baseline serum albumin and body mass index, the presence of baseline hypomagnesemia and lower baseline serum potassium were independently associated with hypokalemia after furosemide treatment. Prior use of spironolactone was associated with a decreased risk of hypokalemia. Patients in the hypokalemia group had significantly higher incidence of cardiac arrhythmia and sepsis compared with the non-hypokalemia group.
Conclusion: Close monitoring of serum potassium among high risk patients may help reduce the incidence of hypokalemia and adverse clinical outcomes in hospitalized patients with ADHF who received furosemide.
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