PT - JOURNAL ARTICLE AU - Kun Kim AU - Reimar Wernich Thomsen AU - Sia Kromann Nicolaisen AU - Lars Pål Hasvold AU - Eirini Palaka AU - Henrik Toft Sørensen TI - Healthcare resource utilisation and cost associated with elevated potassium levels: a Danish population-based cohort study AID - 10.1136/bmjopen-2018-026465 DP - 2019 Apr 01 TA - BMJ Open PG - e026465 VI - 9 IP - 4 4099 - http://bmjopen.bmj.com/content/9/4/e026465.short 4100 - http://bmjopen.bmj.com/content/9/4/e026465.full SO - BMJ Open2019 Apr 01; 9 AB - Objectives To investigate healthcare costs associated with hyperkalaemia (HK) among patients with chronic kidney disease (CKD), heart failure (HF) or diabetes.Design Before–after cohort study of patients with HK and matched patients without HK.Setting Population-based databases covering primary and secondary care for the entire of Northern Denmark.Participants Patients with a first incident record of CKD (n=78 372), HF (n=14 233) or diabetes (n=37 479) during 2005–2011. Among all patients experiencing a first HK event (potassium level >5.0 mmol/L), healthcare costs were compared during 6 months before and 6 months after the HK event. The same cost assessment was conducted 6 months before and after a matched index date in a comparison cohort of patients without HK.Primary and secondary outcome measures Mean costs of hospital care, general practice and dispensed drugs converted to 2018 Euros.Results Overall, 17 747 (23%) CKD patients, 5141 (36%) HF patients and 4183 (11%) diabetes patients with a first HK event were identified. More than 40% of all HK patients across the patient groups had subsequent HK events with successively shorter times between the events. In CKD patients, overall mean costs were €5518 higher 6 months after versus before first HK, while €441 higher in matched CKD patients without HK, yielding HK-associated costs of €5077. Corresponding costs associated with a HK event were €6018 in HF patients, and €4862 in diabetes patients.Conclusions Among CKD, HF and diabetes patients, an incident HK event was common, and a large proportion of the patients experienced recurrent HK events. Substantial increase in healthcare costs associated with a HK event was observed in the HK patients compared with non-HK patients. These results are important to better understand the potential economic impact of HK among high-risk comorbid patients in a real-wold setting and help inform decision-making for clinicians and healthcare providers.