Evaluation of the Frequency of Hypokalemia in Patients on Diuretic Therapy for Heart Failure.

BACKGROUND

Hypokalemia is one of the frequent and clinically important electrolyte disturbances in patients with heart failure (HF), especially among patients under diuretic treatment. The objective of this study was to evaluate the occurrence of hypokalemia and determine clinical predictors of this condition in patients with HF hospitalized on diuretics.

METHODS

A cross-sectional study was conducted on 150 patients with HF in a hospital. Patients who were taking loop or thiazide diuretics for at least one week were included. The participants were divided into the hypokalemic (K < 3.5 mmol/L, n = 47) and normokalemic (K ≥ 3.5 mmol/L, n = 103) groups, based on serum potassium. The demographics, comorbidities, type and dose of diuretic, and other clinical variables were also collected. An automated ion-selective electrode analyzer was utilized to determine the concentration of potassium. SPSS 26.0 (IBM Corp., Armonk, NY, US) was used for data analysis with the p-value < 0.05 as significant.

RESULTS

The prevalence of hypokalemia in the study population was 47 (31.3%). It strongly correlated with the use of loop diuretics (34 (72.3%) vs. 54 (52.4%), p = 0.042), high-dose diuretics (23 (48.9%) vs. 30 (29.1%), p = 0.015), and the presence of diabetes mellitus (18 (38.3%) vs. 23 (22.3%), p = 0.028). Loop diuretic use (odds ratio (OR) = 2.10, p = 0.023) and its high dose (OR = 1.80, p = 0.018) were the independent predictors of hypokalemia by logistic regression analysis.

CONCLUSION

The study demonstrated that hypokalemia was common among HF patients receiving diuretic therapy, particularly loop diuretics in high doses. Although loop diuretic use and higher doses were significant independent predictors, the efficacy of interventions like dose adjustment or potassium-sparing drugs needs to be further validated in future randomized controlled trials.