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News

Hyperkalemia in hospitalized patients with cirrhotic ascites indicates a poor prognosis

Moderate hyperkalemia in hospitalized patients with cirrhotic ascites indicates a poor prognosis, reports the Scandanavian Journal of Gastroenterology.

News image

Development of ascites in patients with liver cirrhosis is an ominous sign with a poor outcome.

A liver transplantation must be considered, and it then becomes important to know if there are any factors indicating a worsened prognosis.

Dr Sven Wallerstedt and colleagues from Sweden reported that they used official registers for a follow-up study of at least 5 years considering the prognosis of 155 prospectively recruited in-patients with cirrhotic ascites from medical units at 9 Swedish university hospitals.

All patients had undergone at least 1 diagnostic ascites tap, and had initially been questioned about background factors and physically examined according to a standardized case record form, followed by sampling of blood, urine, and ascites.

The doctors noted that death occurred within 1 year after inclusion in 53% of the cases, and was primarily liver-related in 70%.

Potassium concentration was related to renal function
Scandinavian Journal of Gastroenterology

In a multivariable analysis, the 2 ordinary variables that showed the strongest correlation with risk of death were serum potassium and abdominal tenderness.

The research team assessed that all 22 patients with a serum potassium concentration of at least 4.8 mmol/L died within 1 year after inclusion.

Potassium concentration was related to renal function and potassium-saving drugs.

Dr Wallerstedt's team comments, "This follow-up study of a prospectively recruited cohort of in-patients with cirrhotic ascites confirms their poor prognosis."

"Awareness of an elevated serum potassium value, which would reflect a threatened renal function, seems essential, because it may offer a simple way to identify cases with the worst prognosis."

"An area for further research should be to explore the significance of including serum potassium in prognostic models."

Scand J Gastroenterol 2013: 48(3): 358-365
06 March 2013

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