Prevalence and Factors Associated with Potassium Abnormalities Among Outpatients with Heart Failure Taking Diuretics in a Tertiary Referral Hospital in Tanzania

TL;DR

This study found that nearly a quarter of heart failure patients on diuretics in Tanzania had potassium imbalances, with severity linked to kidney disease and more advanced heart failure.

Contribution

The study provides new insights into potassium abnormalities in heart failure patients in a Tanzanian setting.

Findings

The prevalence of hypokalemia was 4.3% and hyperkalemia was 19.3% among patients.

Factors like medication use, kidney disease, and severe heart failure were associated with potassium imbalances.

Regular electrolyte monitoring is recommended for early detection and intervention.

Abstract

Heart failure (HF) is a chronic progressive condition in which the heart is unable to pump enough blood to meet the body's need for blood and oxygen. Globally, about 64 million people are affected with HF. This study was undertaken to determine the magnitude and factors associated with potassium abnormalities in heart failure patients on diuretics in Tanzania.

This was a hospital based cross-sectional study conducted at Bugando Medical Centre's outpatient clinic. The selection of this hospital was driven by the significant presence of heart failure patients in the facility and the convenience for the researchers, who were stationed at this facility during the study period. All consenting adult patients aged 18 years and above that were attending the cardiac clinic and had met Framingham criteria for heart failure and were taking diuretics for at least one month were included.

The prevalence of hypokalemia and hyperkalemia was found to be 4.3% And 19.3% respectively. The median (IQR) age was 61 (46-70) years and majority of them (52.8%) were females. most of the patients (87.7%) had New York Heart Association (NYHA) class III heart failure.

Factors associated with potassium abnormalities include medication use, kidney disease and more severe heart failure. Healthcare providers should ensure that all patients with these associated factors receive regular electrolyte testing. Electrolytes should be part of the baseline investigation to all patients with heart failure starting treatment, and should be closely monitored in every clinic visit for early detection of these abnormalities and possible intervention, including dose adjustments.