scholarly journals Study of Neuroimaging in Patients with Refractory Eclampsia

2013 ◽  
Vol 5 (1) ◽  
pp. 4-7
Author(s):  
Mithil M Patil
Keyword(s):  
Developing Countries ◽  
Sinus Thrombosis ◽  
High Risk Patient ◽  
Radiation Hazard ◽  
List Type ◽  
Ct Scanner ◽  
Pathological Conditions ◽  
Number Of Patients ◽  
Increased Risk ◽  
Prospective Study Design

ABSTRACT Need Despite availability of intensive care units and improved antenatal care some women still die from eclampsia. Eclampsia is associated with increased risk of maternal death from 1.8% in developing countries to 14% in developing countries. Cerebral complications are the major cause of death in eclampsia patients. Eclampsia along with hypercoagulopathy of pregnancy is a high risk patient for development of cerebrovascular thrombosis/ischemic strokes. Eclampsia patients who are refractory to the routine treatment have been found to have various CNS pathological conditions amenable to the medical treatment. Aim and objectives To study the neurological changes in patients with eclampsia and to delineate the pathophysiology in patients with refractory eclampsia. Materials and methods Prospective study design where 30 patients were included in the study. All patients were admitted in the eclampsia room with h/o convulsions. All patients were put on MgSO4 therapy and antihypertensives. The patients who are refractory to the treatment, such as having recurrent convulsions despite on MgSO4 were selected for neuroimaging with CT scan. neuroimaging is done with Phillips Tomoscan CT scanner where slices of 10 mm thickness were taken through the entire brain in the transaxial plane. Abdomen shielding is done with lead shield to prevent radiation hazard. Results Sr. Findings Number of patients Percentage 1 Cerebral edema 20 Mild to moderate 17 56 Severe 3 10 2 Hypertensive encephalopathy 5 16 3 Posterior reversible encephalopathy syndrome 11 36 4 Cerebral infarction 4 13 5 Cortical venous sinus thrombosis 2 16 6 Tuberculomas 2 6 7 Meningitis 1 3 8 Hydrocephalus 1 3 9 Normal 4 13 Conclusion Eclampsia patients who were refactory to the treatment with MgSO4 and antihypertensives have been found to have very significant and morbid CNS pathological conditions. Neuroimaging in this patients have done a pivotal role in identifying the abnormality and rectifying it with medical means which has surely improved patients condition and have reduced morbidity. How to cite this article Patil MM. Study of Neuroimaging in Patients with Refractory Eclampsia. J South Asian Feder Obst Gynae 2013;5(1):4-7.

scholarly journals Convulsions in pregnancy-not always eclampsia role of neuro-imaging in diagnostic dilemma

2017 ◽  
Vol 13 (3) ◽  
pp. 144-151
Author(s):  
M. Vijayasree ◽  
GV Murali
Keyword(s):  
Sinus Thrombosis ◽  
Developed Countries ◽  
Radiation Hazard ◽  
Diagnostic Dilemma ◽  
Pathological Conditions ◽  
Increased Risk ◽  
Neuro Imaging ◽  
Prospective Study Design ◽  
In Pregnancy

Background: Convulsions in pregnancy is always considered and treated as Eclampsia unless otherwise proved. Eclampsia is associated with increased risk of maternal death varying from 1.8 % to 14 % in developed countries. Despite availability of Intensive care units and improved antenatal care, some women still die from Eclampsia. Cerebral complications are the major cause of death in eclampsia patients. Hypercoagulopathy of pregnancy is a high risk factor for these patients in respect to development of cerebro vascular thrombosis and ischaemic strokes. Eclampsia patients who are refractory to the routine treatment have been found to have various Central Nervous System pathological conditions amenable to the medical treatment.Objective: To study the neuro pathophysiology behind a seizure in pregnancy and to reduce the morbidity associated with it. To study the role of neuro-imaging in patients with convulsions in pregnancy not responding to treatment with magnesium sulphate (MgSo4).Methods: It was a prospective study design which included 50 antenatal mothers. All patients were admitted in the eclampsia room with history of convulsions and all of them were put on MgSo4 therapy and Antihyperertensives. The patients who were refractory to the treatment such as having recurrent convulsions despite therapy with MgSo4 were selected for neuro- imaging with Computed Tomography scan. Neuro-imaging was done using Phillips Tomoscan CT scanner where slices of 10-mm thickness were taken through the entire brain in the trans-axial plane. Abdomen shielding was done with lead shield to prevent radiation hazard in the antenatal period.The results were documented and analysed using appropriate statistical method.Results: The CT scanning report revealed: Cerebral oedema (30/50), Encephalopathy (10/50), Intra Cranial Haemorrhage (02/50) Cerebral infarction (01/50), Cortical venous sinus thrombosis (01/50), Tuberculomas (01/50), Neurocysticercosis (01/50) and Hydrocephalus (01/50). Three patients out of 50 had normal CT scan report. Conclusion: Patients with convulsions in pregnancy who were refractory to the treatment with MgSo4 and Antihypertensives have been found to have very significant and morbid CNS pathological conditions. Neuro imaging in these patients have done a pivotal role in identifying the abnormality and rectifying it with medical means which had definitely improved patients conditions and have reduced morbidity and mortality. Health Renaissance 2015;13 (3): 144-151

PALB2 mutations in Brazilian patients from North-Northeast regions.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13670-e13670
Author(s):  
Thamara Ferreira ◽  
Thais Ferreira Bomfim-Palma ◽  
Isabelle Joyce de Lima Silva-Fernandes ◽  
Gabriela Espirito Santo Felix ◽  
Inacelli Queiroz De Souza Caires ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Male Breast Cancer ◽  
Clinical Management ◽  
Susceptibility Gene ◽  
High Risk Patient ◽  
Male Breast ◽  
The North ◽  
Number Of Patients ◽  
Increased Risk

e13670 Background: Loss-of-function mutations in PALB2 gene are associated with increased risk for breast cancer and possibly pancreatic, ovarian, male breast, prostate, colorectal as others cancers. In Brazil it has been estimated that up to 1,516 new cases of hereditary breast cancer for 2020 in the North and Northeast regions. Analysis of susceptibility gene mutations helps identify precisely the high-risk patient and their families, whom need specific and personalized clinical management as high-risk individuals. Methods: Twenty-six patients with pathogenic mutations in PALB2 gene identify by next-generation sequencing from states of Bahia (11), Ceará (9), Pernambuco (5) and Rondônia (1) in the North and Northeast regions were analyzed. Results: Most of the patients analyzed had only breast cancer (80%), including two cases of male breast cancer (9,5%); the others were isolated cases of endometrial cancer (4%), breast and pancreas cancers (4%), breast and lung cancers (4%), only ovarian cancer (4%) and ovarian and breast cancers (4%). Most cancers were stage II or III (65%). Family history of cancer was observed in 22/26 (84%); the most common tumors were breast, prostate, pancreas and thyroid. The founder mutations were more frequent in exons: 4 (58%) and 12 (15%). Eleven variants were found as follow: c.1240C > T (19%); c.3256delC (15%); c.1671_1674delTATT (11.5%); c.355delC (11.5%); NC_000016.9:g.(?_23632673)_(23652488_?)del (11,5%). The greatest variety of mutations was found in the state of Bahia, probably due to the greater number of patients included (42%). Conclusions: These data suggest that changes in clinical management of PALB2 patients are needed since the phenotype observed exhibited pattern of hereditary tumors, including male breast cancer. Besides that, PALB2 gene should be included in painel gene analysis in patients from the North and Northeast of Brazil because its high frequency of pathogenic variants.

scholarly journals Current routines for antibiotic prophylaxis prior to transrectal prostate biopsy: a national survey to all urology clinics in Sweden

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 58 ◽  
Author(s):  
Johan Styrke ◽  
Sven Resare ◽  
Karl-Johan Lundström ◽  
Patrick Masaba ◽  
Christofer Lagerros ◽  
...  
Keyword(s):  
Single Dose ◽  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Prostate Biopsy ◽  
High Risk Patient ◽  
Guideline Recommendation ◽  
Risk Of Infection ◽  
Urine Dipstick ◽  
Number Of Patients ◽  
Increased Risk

Background: The risk of infection after transrectal ultrasound (TRUS)-guided prostate biopsies is increasing. The aim of the study was to assess the use of antibiotic prophylaxis for prostate biopsy in Sweden. Methods: All public and private urology clinics reporting to the National Prostate Cancer Register of Sweden received a survey on TRUS-biopsy prophylaxis. Results: Of the 84 clinics surveyed, 76 replied (90%). If no risk factors for infection were present, a single dose of ciprofloxacin 750 mg was used by 50 clinics (66%). Multiple doses of ciprofloxacin 500 or 750 mg (n=14; 18%) or a single dose of trimethoprim-sulfamethoxazole 160/800 mg (n=7; 9%) were other common prophylaxes. Most clinics gave the prophylaxes immediately before the biopsy (n=41; 54%). Urine dipstick was used by 30 clinics (39%) and rectal enema by six (8%). In patients with high risk of infection, the survey mirrors a large variety of regiments used. Conclusions: The preference to use a single dose of ciprofloxacin 750 mg is in accordance with the Swedish national guidelines for patients with a low risk of infection. Better compliance to the guideline recommendation to use a urine dipstick would probably increase the number of patients classified as having an increased risk of infection. Being classified as a high-risk patient should lead to an extended duration of antibiotic prophylaxis, however, the variety of regimens used in the high-risk group reflects an inability to treat these patients in a standardized fashion and also highlights a need for more clear-cut guidelines. Pre-biopsy identification of high-risk patients is an important issue to tackle for the urologic clinics in order to reduce the number of infections.

scholarly journals P014 An audit of bone health assessment in patients admitted to hospital with a fracture following a fall

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
James Kimpton ◽  
Barnaby Wong ◽  
Raj Amarnani ◽  
Martin Loader ◽  
Christopher Fong ◽  
...  
Keyword(s):  
Bone Health ◽  
Health Assessment ◽  
High Risk Patient ◽  
Fragility Fractures ◽  
Post Discharge ◽  
Neck Of Femur ◽  
Number Of Patients ◽  
Increased Risk ◽  
Health And Social Care ◽  
The Uk

Abstract Background/Aims  Over three million people in the UK have osteoporosis; and are at a substantially increased risk of fragility fractures. There are approximately 536,000 new fragility fractures each year in the UK, with substantial associated morbidity and health service burden. Preventing fragility fractures is thus clinically and economically important and will result in substantial savings for health and social care. The aim of this audit was to assess and improve falls and bone health assessments in a high-risk patient group at a central London hospital. Methods  Data was collected over a 2-month period (02/05/2019-28/06/2019) of consecutive patients over the age of 50 admitted to hospital following a fall and fracture. We used the 2017 National Osteoporosis Guidelines Group, NICE clinical guideline on falls in older people (CG161) and the local hospital osteoporosis screening policy as the audit standards. Patient notes were reviewed to assess for evidence of bone health assessment and key falls assessment domains having taken place. Results  43 patients were included; 8 of which had a neck of femur fracture (NOF). Table 1 demonstrates the different components that we included in the falls assessment. Only 5 (12%) of all of the patients had a full falls assessment recorded. In all domains, patients with a NOF were more likely to have a more complete falls assessment than patients with other fractures, especially fundamental components such as osteoporosis risk assessment. P014 Table 1:Number of patients who had each aspect of the falls and bone health assessment completedNOF (N = 8, mean age=80.3)Non-NOF (N = 35, mean age=75.3)YesNoPartialYesNoPartialFalls Assessment3 (37.5%)0 (0%)5 (62.5%)2 (5.7%)15 (42.9%)18 (51.4%)Medical diagnosis of aetiology7 (87.5%)1 (12.5%)18 (51.4%)17 (48.6%)Lying/standing BP3 (37.5%)5 (62.5%)5 (14.3%)30 (85.7%)Therapies assessment?8 (100%)0 (0%)24 (68.6%)11 (31.4%)Medication review?6 (75%)2 (25%)10 (28.6%)25 (71.4%)Osteoporosis assessment?8 (100%)0 (0%)9 (25.7%)26 (74.3%)FRAX completed3 (37.5%)5 (62.5%)3(8.6%)32 (91.4%)Referred to falls clinic1 (12.5%)7 (87.5%)1 (2.9%)34 (97.1%)Referred to post discharge falls prevention5 (62.5%)3 (37.5%)3 (8.6%)32 (91.4%)Referred to bone health clinic1 (12.5%)7 (87.5%)0 (0%)35 (100%)Patients divided into groups of neck of femur (NOF) and non-NOF fractures Conclusion  Key aspects of falls and bone health assessment are simple and quick to do, yet often not done in patients admitted with a fracture following a fall. These measures are highly valuable in the long term to mitigate future fragility fracture risk. Our results show that post fall assessment, including bone health, are performed more often in patients with NOF than non-NOF fractures. There is large scope for improvement in practice for this at-risk cohort of patients. Therefore, going forward, our next steps are to create an education programme and embed a standardised, simple proforma into electronic healthcare records to guide post fall bone health assessment. Disclosure  J. Kimpton: None. B. Wong: None. R. Amarnani: None. M. Loader: None. C. Fong: None. I. Mannan: None.

Comparative analysis of polymorphic variants of IL-17A and MMP-1 genes with the risk of developing chronic periodontitis in petrochemical workers

2020 ◽  
Vol 60 (10) ◽  
pp. 687-693
Author(s):  
Iskander I. Zaidullin ◽  
Denis O. Karimov ◽  
Lilija K. Karimova ◽  
Milyausha F. Kabirova ◽  
Rasima R. Galimova ◽  
...  
Keyword(s):  
Ethylene Oxide ◽  
Chronic Periodontitis ◽  
Periodontal Diseases ◽  
Clinical Manifestations ◽  
Control Group ◽  
Periodontal Tissues ◽  
Dental Examination ◽  
Number Of Patients ◽  
Increased Risk ◽  
Harmful Substances

The susceptibility to the development and progression of inflammatory periodontal diseases, which depends on genetic and external factors (smoking, stress, oral hygiene), varies widely. In the development of these diseases, an important role is played not only by the presence of periodontal pathogenic microorganisms, but also by the presence of congenital or acquired immunodeficiency, immunoregulatory defects. The immune system plays a key role in the physiological and pathological processes of periodontal tissues. In this regard, IL17, produced by CD4+ Th cells, which has both Pro-inflammatory and protective activity, is of particular interest in the pathogenesis of periodontitis. The aim of study was to identify the relationship between polymorphic loci of the IL-17A (rs2275913) and MMP-1 (rs1799750) genes and clinical manifestations of chronic periodontitis in petrochemical workers. Dental examination was performed in 92 ethylene oxide production workers with chronic periodontitis and 74 patients with chronic periodontitis who did not come into contact with chemical factors (control group). Genotyping of polymorphisms rs2275913 of the IL17A gene and rs1799750 of the MMP1 gene was performed by allele-specific real-time polymerase chain reaction (PCR). Hygienic assessment of the degree of air pollution of the working area with harmful substances was carried out by gas chromatography according to the guidelines for the determination of harmful substances in the air № 5098-89, № 3119-84. When comparing the results of studies of both groups, there were no statistically significant differences in the frequency distributions of allelic variants and genotypes of the IL-17A and MMP-1 genes. The AA/AG genotypes of the IL-17A gene were associated with an increased risk of severe disease compared to the GG genotype in workers in the main group (OR=6.1; 95% CI 1.33-28.5; p=0.021) and in the control group (OR=7.26; 95% CI 1.34-39.25; p=0.016). Carriers of the A allele in the control group increased the risk of severe chronic periodontitis by 2.4 times compared to carriers of the G allele (OR=2.41; 95% CI 1.19-4.87; p=0.014). During the dental examination of employees of the ethylene oxide plant, the clinical course of periodontal diseases was more severe in comparison with the control group, and the number of patients with severe periodontitis was twice as high. It was found that the AA/AG genotypes of the IL-17A gene and the carrier of the A allele are associated with increased susceptibility to the development of severe chronic periodontitis. The association between the MMP-1 gene polymorphism and the risk of severe forms of chronic periodontitis has not been established. A risk factor for the development of inflammatory periodontal diseases in employees of the petrochemical complex is a complex of harmful production factors.

PREVALENCE OF CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII (CRAB) IN MEDICAL AND SURGICAL INTENSIVE CARE UNITS (ICUS) OF JPMC, KARACHI

2019 ◽  
Author(s):  
Rabia Arshad
Keyword(s):  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Acinetobacter Baumannii ◽  
Intensive Care Units ◽  
Carbapenem Resistance ◽  
Chronic Obstructive ◽  
Surgical Intensive Care ◽  
Carbapenem Resistant ◽  
Number Of Patients ◽  
Increased Risk

Background: Antimicrobial resistance is one of the research priorities of health organizations due to increased risk of morbidity and mortality. Outbreaks of nosocomial infections caused by carbapenem-resistant Acinetobacter Baumannii (CRAB) strains are at rise worldwide. Antimicrobial resistance to carbapenems reduces clinical therapeutic choices and frequently led to treatment failure. The aim of our study was to determine the prevalence of carbapenem resistance in A. baumannii isolated from patients in intensive care units (ICUs). Methods: This cross-sectional study was carried out in the Department of Microbiology, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Centre (JPMC), Karachi, from December 2016 to November 2017. Total 63 non-repetitive A. baumannii were collected from the patients’ specimens, admitted to medical and surgical ICUs and wards of JPMC, Karachi. The bacterial isolates were processed according to standard microbiological procedures to observe for carbapenem resistance. SPSS 21 was used for data analysis. Results: Out of the 63 patients, 40 (63.5%) were male. The age of the patient ranged from 15-85 year, with average of 43 year. 34.9% patients had been hospitalized for 3 days. Chronic obstructive pulmonary disease was present in highest number with average of 58.7% for morbidity. Number of patients on mechanical ventilation was highest (65.1%). All isolates were susceptible to colistin. The resistance to ampicillin-sulbactam, ceftazidime, ciprofloxacin, amikacin, piperacillin- tazobactam and meropenem was 82.5%, 81%, 100%, 87.3%, 82.5% and 82% respectively. Out of 82% CRAB, 77% were obtained from ICUs. Conclusion: This study has revealed the high rate of carbapenem resistance in A. baumannii isolates in ICUs thus leaving behind limited therapeutic options.

PP159 Telemedicine In Paraguay: Contributions Of The Institute Of Health Sciences Research, National University Of Asunción

2020 ◽  
Vol 36 (S1) ◽  
pp. 18-18
Author(s):  
Ronald Rivas ◽  
Pedro Galván
Keyword(s):  
Public Health ◽  
Biomedical Engineering ◽  
List Type ◽  
Telemedicine System ◽  
Cellular Telephony ◽  
Imaging Department ◽  
Number Of Patients ◽  
Computed Tomography Scans ◽  
National University ◽  
Development And Validation

IntroductionThe modalities of telemedicine that have been developed and applied so far by the Department of Biomedical Engineering and Imaging at the National University of Asunción (IICS-UNA) are as follows: (i) telediagnosis: the remote sending of data, signals, and images for diagnostic purposes; (ii) general telediagnostic imaging; (iii) telemonitoring (including telemetry): remote monitoring of vital parameters to provide automatic or semi-automatic surveillance or alarm services in emergencies, epidemiology, or tele-public health; and (iv) tele-education: the use of telematic networks to provide virtual platforms for educating and training health professionals.MethodsWe conducted a comprehensive review of the scientific works developed by the IICS-UNA in order to evaluate the systematic implementation of Telemedicine in Paraguay. Documents, pilot projects (satellite telegraphy), telediagnostic research, telematics, tele-education, published articles, and statistical data (number of patients attending or studies performed, etcetera) relating to the implementation of the National Telemedicine System by the Ministry of Public Health and Social Welfare since 1999 were reviewed.ResultsImplementation of the telemedicine system has meant that 472,038 patients have attended referral centers nationwide, with 297,999 electrocardiographs, 165,323 computed tomography scans, and 8,697 electroencephalograms being conducted. Projects developed within the framework of the Telemedicine Research Line have included the following: (i)Development and validation of a clinical telemicroscopy system based on cellular telephony;(ii)Implementation of a telemetry system for temperature monitoring of the collection of biological samples from a biomedical research center; and(iii)Production and development of a virtual campus at the National University of Asunción.ConclusionsGiven the current healthcare environment, developing a line of research based on telemedicine is a proactive step, since telemedicine provides an alternative solution to the problem of access to the health system. That is why the IICS-UNA Biomedical Engineering and Imaging Department has developed telemedicine as one of its main lines of research.

scholarly journals Task shifting in the care for patients with hand osteoarthritis. Protocol for a randomized controlled non-inferiority trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ingvild Kjeken ◽  
Kjetil Bergsmark ◽  
Ida K. Haugen ◽  
Toril Hennig ◽  
Merete Hermann-Eriksen ◽  
...  
Keyword(s):  
Health Care ◽  
Disease Activity ◽  
Primary Outcome ◽  
Hand Osteoarthritis ◽  
List Type ◽  
Specialist Care ◽  
Randomized Controlled ◽  
Number Of Patients ◽  
Specialist Health Care ◽  
And Function

Abstract Background Current health policy states that patients with osteoarthritis (OA) should mainly be managed in primary health care. Still, research shows that patients with hand OA have poor access to recommended treatment in primary care, and in Norway, they are increasingly referred to rheumatologist consultations in specialist care. In this randomized controlled non-inferiority trial, we will test if a new model, where patients referred to consultation in specialist health care receive their first consultation by an occupational therapy (OT) specialist, is as safe and effective as the traditional model, where they receive their first consultation by a rheumatologist. More specifically, we will answer the following questions: What are the characteristics of patients with hand OA referred to specialist health care with regards to joint affection, disease activity, symptoms and function? Is OT-led hand OA care as effective and safe as rheumatologist-led care with respect to treatment response, disease activity, symptoms, function and patient satisfaction? Is OT-led hand OA care equal to, or more cost effective than rheumatologist-led care? Which factors, regardless of hand OA care, predict improvement 6 and 12 months after baseline? Methods Participants will be patients with hand OA diagnosed by a general practitioner and referred for consultation at one of two Norwegian departments of rheumatology. Those who agree will attend a clinical assessment and report their symptoms and function in validated outcome measures, before they are randomly selected to receive their first consultation by an OT specialist (n = 200) or by a rheumatologist (n = 200). OTs may refer patients to a rheumatologist consultation and vice versa. The primary outcome will be the number of patients classified as OMERACT/OARSI-responders after six months. Secondary outcomes are pain, function and satisfaction with care over the twelve-month trial period. The analysis of the primary outcome will be done by logistic regression. A two-sided 95% confidence interval for the difference in response probability will be formed, and non-inferiority of OT-led care will be claimed if the upper endpoint of this interval does not exceed 15%. Discussion The findings will improve access to evidence-based management of people with hand OA. Trial registration ClinicalTrials.gov, NCT03102788. Registered April 6th, 2017, https://clinicaltrials.gov/ct2/show/NCT03102788?term=Kjeken&draw=2&rank=1 Date and version identifier: December 17th, 2020. First version.

scholarly journals Estimating the burden of hyperkalaemia in the UK in high-risk patient populations

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P McEwan ◽  
L Hoskin ◽  
K Badora ◽  
D Sugrue ◽  
G James ◽  
...  
Keyword(s):  
Clinical Practice ◽  
High Risk ◽  
Patient Outcomes ◽  
Real World ◽  
High Risk Patient ◽  
Incidence Rates ◽  
Funding Source ◽  
Eligible Population ◽  
Increased Risk ◽  
The Uk

Abstract Background Patients with chronic kidney disease (CKD), heart failure (HF), resistant hypertension (RHTN) and diabetes are at an increased risk of hyperkalaemia (HK) which can be potentially life-threatening, as a result of cardiac arrhythmias, cardiac arrest leading to sudden death. In these patients, renin-angiotensin-aldosterone system inhibitors (RAASi), are used to manage several cardiovascular and renal conditions, and are associated with an increased risk of HK. Assessing the burden of HK in real-world clinical practice may concentrate relevant care on those patients most in need, potentially improving patient outcomes and efficiency of the healthcare system. Purpose To assess the burden of HK in a real-world population of UK patients with at least one of: RHTN, Type I or II diabetes, CKD stage 3+, dialysis, HF, or in receipt of a prescription for RAASi. Methods Primary and secondary care data for this retrospective study were obtained from the UK Clinical Practice Research Datalink (CPRD) and linked Hospital Episode Statistics (HES). Eligible patients were identified using READ codes defining the relevant diagnosis, receipt of indication-specific medication, or, in the case of CKD, an estimated glomerular filtration rate (eGFR) ≤60 ml/min/1.73m2 within the study period (01 January 2008 to 30 June 2018) or in the five-year lookback period (2003–2007). The index date was defined as 01 January 2008 or first diagnosis of an eligible condition or RAASi prescription, whichever occurred latest. HK was defined as K+ ≥5.0 mmol/L; thresholds of ≥5.5 mmol/L and ≥6.0 mmol/L were explored as sensitivity analyses. Incidence rates of HK were calculated with 95% confidence intervals (CI). Results The total eligible population across all cohorts was 931,460 patients. RHTN was the most prevalent comorbidity (n=317,135; 34.0%) and dialysis the least prevalent (n=4,415; 0.5%). The majority of the eligible population were prescribed RAASi during follow-up (n=754,523; 81.0%). At a K+ threshold of ≥5.0 mmol/L, the dialysis cohort had the highest rate of HK (501.0 events per 1,000 patient-years), followed by HF (490.9), CKD (410.9), diabetes (355.0), RHTN (261.4) and the RAASi cohort (211.2) (Figure 1). This pattern was still observed at alternative threshold definitions of HK. Conclusion This large real-world study of UK patients demonstrates the burden of hyperkalaemia in high-risk patient populations from the UK. There is a need for effective prevention and treatment of HK, particularly in patients with CKD, dialysis or HF where increased incidence rates are observed which in turn will improve patient outcomes and healthcare resource usage. Figure 1. Rates of HK by condition Funding Acknowledgement Type of funding source: Private company. Main funding source(s): AstraZeneca

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