{"title":"A Comparative Study Assessing the Incidence and Degree of Hyperkalemia in Patients on Unfractionated Heparin versus Low-Molecular Weight Heparin.","authors":"Lina Naseralallah, Dima Nasrallah, Somaya Koraysh, Shimaa Aboelbaha, Tarteel Ali Hussain","doi":"10.2147/CPAA.S487288","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Heparin and its derivates, including unfractionated heparin (UFH) and low molecular weight heparin (LMWH), are among the most commonly used anticoagulants. Nonetheless, their use has been associated with hyperkalemia.</p><p><strong>Objective: </strong>To determine and compare the incidence, magnitude, and potential risk factors of hyperkalemia in patients receiving UFH versus LMWH in a real-world clinical setting.</p><p><strong>Methods: </strong>A retrospective observational study was conducted involving all adult hospitalized patients who received UFH, dalteparin or enoxaparin. Electronic medical records were reviewed over a 12-month period, collecting data on demographic, laboratory, comorbidity, and medication-related variables. Data were analyzed using multivariate logistic regression.</p><p><strong>Results: </strong>A total of 929 patients met the eligibility criteria, with a mean age of over 40 years across all groups. Of these, 56.3%, 17.2%, and 15.7% experienced hyperkalemia with UFH, dalteparin and enoxaparin, respectively. The incidence of hyperkalemia was significantly higher with UFH compared to enoxaparin and dalteparin (p<0.001). Diabetes mellitus was associated with a higher incidence of hyperkalemia (OR 1.79, 95% CI 1.241-2.581, p=0.002), as was the concomitant use of co-trimoxazole (OR 2.244, 95% CI 1.137-4.426, p=0.02). Whilst chronic kidney disease and the use of two or more hyperkalemia-inducing agents were not statistically significant, they were retained in the model as they were associated with more than a 10% increase in the odds of hyperkalemia.</p><p><strong>Conclusion: </strong>Heparin (UFH, LMWH) administration was associated with a risk of hyperkalemia particularly in patients with diabetes mellitus and those concurrently receiving co-trimoxazole.</p>","PeriodicalId":10406,"journal":{"name":"Clinical Pharmacology : Advances and Applications","volume":"16 ","pages":"33-40"},"PeriodicalIF":3.1000,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646396/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Pharmacology : Advances and Applications","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/CPAA.S487288","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Heparin and its derivates, including unfractionated heparin (UFH) and low molecular weight heparin (LMWH), are among the most commonly used anticoagulants. Nonetheless, their use has been associated with hyperkalemia.
Objective: To determine and compare the incidence, magnitude, and potential risk factors of hyperkalemia in patients receiving UFH versus LMWH in a real-world clinical setting.
Methods: A retrospective observational study was conducted involving all adult hospitalized patients who received UFH, dalteparin or enoxaparin. Electronic medical records were reviewed over a 12-month period, collecting data on demographic, laboratory, comorbidity, and medication-related variables. Data were analyzed using multivariate logistic regression.
Results: A total of 929 patients met the eligibility criteria, with a mean age of over 40 years across all groups. Of these, 56.3%, 17.2%, and 15.7% experienced hyperkalemia with UFH, dalteparin and enoxaparin, respectively. The incidence of hyperkalemia was significantly higher with UFH compared to enoxaparin and dalteparin (p<0.001). Diabetes mellitus was associated with a higher incidence of hyperkalemia (OR 1.79, 95% CI 1.241-2.581, p=0.002), as was the concomitant use of co-trimoxazole (OR 2.244, 95% CI 1.137-4.426, p=0.02). Whilst chronic kidney disease and the use of two or more hyperkalemia-inducing agents were not statistically significant, they were retained in the model as they were associated with more than a 10% increase in the odds of hyperkalemia.
Conclusion: Heparin (UFH, LMWH) administration was associated with a risk of hyperkalemia particularly in patients with diabetes mellitus and those concurrently receiving co-trimoxazole.