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Patient- and physician-related risk factors for hyperkalaemia in potassium-increasing drug-drug interactions

Eschmann, Emmanuel ; Beeler, Patrick ; Kaplan, Vladimir ; Schneemann, Markus ; Zünd, Gregor ; Blaser, Jürg

In: European Journal of Clinical Pharmacology, 2014, vol. 70, no. 2, p. 215-223

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    Titel
    • Patient- and physician-related risk factors for hyperkalaemia in potassium-increasing drug-drug interactions
    Autor
    • Eschmann, Emmanuel. Research Centre for Medical Informatics, Directorate of Research and Education, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
    • Beeler, Patrick. Research Centre for Medical Informatics, Directorate of Research and Education, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
    • Kaplan, Vladimir. Division of Internal Medicine, Kreisspital für das Freiamt Muri, Spitalstrasse 144, 5630, Muri, Switzerland
    • Schneemann, Markus. Division of Internal Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
    • Zünd, Gregor. Directorate of Research and Education, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
    • Blaser, Jürg. Research Centre for Medical Informatics, Directorate of Research and Education, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • European Journal of Clinical Pharmacology, 2014, vol. 70, no. 2, p. 215-223. Springer Berlin Heidelberg
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:326604
    Summary
    Purpose: Hyperkalaemia due to potassium-increasing drug-drug interactions (DDIs) is a clinically important adverse drug event. The purpose of this study was to identify patient- and physician-related risk factors for the development of hyperkalaemia. Methods: The risk for adult patients hospitalised in the University Hospital Zurich between 1 December 2009 and 31 December 2011 of developing hyperkalaemia was correlated with patient characteristics, number, type and duration of potassium-increasing DDIs and frequency of serum potassium monitoring. Results: The 76,467 patients included in this study were prescribed 8,413 potentially severe potassium-increasing DDIs. Patient-related characteristics associated with the development of hyperkalaemia were pulmonary allograft [relative risk (RR) 5.1; p < 0.0001), impaired renal function (RR 2.7; p < 0.0001), diabetes mellitus (RR 1.6; p = 0.002) and female gender (RR 1.5; p = 0.007). Risk factors associated with medication were number of concurrently administered potassium-increasing drugs (RR 3.3 per additional drug; p < 0.0001) and longer duration of the DDI (RR 4.9 for duration ≥6days; p < 0.0001). Physician-related factors associated with the development of hyperkalaemia were undetermined or elevated serum potassium level before treatment initiation (RR 2.2; p < 0.001) and infrequent monitoring of serum potassium during a DDI (interval >48h: RR 1.6; p < 0.01). Conclusion: Strategies for reducing the risk of hyperkalaemia during potassium-increasing DDIs should consider both patient- and physician-related risk factors.