It's Labor Day, but did you know that for people with chronic kidney disease hyperkalemia, it also has a different meaning. In the United States, May 1 is also High Potassium Awareness Day. For patients with chronic kidney disease, the high prevalence of hyperkalemia and the high recurrence rate may lead to serious adverse cardiovascular events and affect patient outcomes [1].
So, what are the dangers of hyperkalemia, what is the background of hyperkalemia awareness day, and what is the vision of the American Association of Kidney Patients (AAKP), the organization that initiated hyperkalemia day?
Not to be overlooked, how much do you know about hyperkalemia?
Hyperkalemia is when the concentration of potassium in the blood exceeds the normal range. Potassium is one of the most important ions in the human body, which plays an important role in maintaining cell metabolism, regulating fluid osmotic pressure, maintaining acid-base balance and maintaining cell stress function. In patients with chronic kidney disease, hyperkalemia is also associated with worse clinical outcomes, with approximately 90 percent increased rates of major adverse cardiovascular events and approximately 65 percent higher mortality rates in patients with chronic kidney disease with hyperkalemia compared with eukalemia [1].
Unfortunately, despite its seriousness, hyperkalemia is not an uncommon electrolyte disorder and is more common in patients with chronic kidney disease [1-2]: in an epidemiological study of hyperkalemia in China, the prevalence of hyperkalemia in outpatients in China was 3.86 percent, and the prevalence of hyperkalemia in patients with chronic kidney disease was as high as 22.89 percent [2]. A real-world study showed that the prevalence of stage 3a, 3b, 4, and 5 hyperkalemia in CKD was 13.22%, 24.56%, 43.65%, and 51.19%, respectively, and the prevalence of hyperkalemia in patients with stage 4 and 5 chronic kidney disease after the use of renin angiotensin system blocker (RASI), a commonly used cardiorenal protective drug, was as high as 51.00% and 62.79%, respectively[3]. More alarmingly, hyperkalemia is a recurrent condition, with recurring episodes of 7.7, 5.9, and 4.8 months between recurring, third, and fourth episodes of hyperkalemia in patients with chronic kidney disease [4].
In view of the high incidence and danger of hyperkalemia in patients with chronic kidney disease, AAKP organized the Hyperkalemia Awareness Day and the Are You O-K+ (Is Your Blood Potassium OK) activities to raise awareness and attention to hyperkalemia among patients and the public through publicity and education [5].
Learn about hyperkalemia awareness days, learn about AAKP
What is Hyperkalemia Awareness Day?This campaign was launched in 2021 by AAKP patient organizations under the theme Are U OK+. K.'s scientific symbol, combined with "How are you?" is not only a simple greeting, but also an expression of concern for the state of one's health. It is hoped that through the care behind each hello, kidney patients, medical professionals, kidney friends, and the public can participate in and understand the story of potassium (pictured).
图 Are You O-K+活动（来源于AAKP官网截图）[5]
The campaign calls for patients to keep their serum potassium concentration below 5.1 mmol/L (the range of serum potassium is 3.5 to 5 mmol/L) [1], so the hyperkalemia awareness date is set on May 1 every year. The purpose of the event is to achieve the following objectives:
01
Raise public awareness of hyperkalaemia. Hyperkalemia Awareness Day and Are You O-K+ events will increase public awareness and understanding of hyperkalemia through online outreach and education, local government announcements, webinars, and more.
Promote communication and patient management among medical staff. Through these two activities, medical staff can enhance learning and communication about hyperkalemia and share the latest research results, treatment methods and management strategies.
03
Helps better prevent and manage hyperkalemia. The presence of hyperkalemia awareness days reminds patients with chronic kidney disease to take proactive preventive measures, such as eating a healthy diet, regular dialysis, and regular use of potassium-lowering drugs, to reduce the risk of hyperkalemia.
As the initiator of High Potassium Day, AAKP also plays an important role. As the largest and oldest independent organization of kidney patients in the United States, AAKP was founded in 1969 by six dialysis patients with the encouragement of physicians. By the Patients also focuses on protecting the needs and rights of people with kidney disease, and is committed to improving the health and well-being of people with kidney disease. AAKP has made unremitting efforts to improve the lives of patients with kidney disease by advocating for legislative reform, advancing patient education and research, conducting public health education, encouraging patient participation in disease management, and recognizing and rewarding those who have made outstanding contributions in the field of kidney disease, and has an important impact on the national and international arenas [5].
Q&A, how can patients with chronic kidney disease prevent hyperkalemia?
A list of potassium-related Q&As for National High K+ Day is also listed on the AAKP website, and some of the highlights are provided to see how patients should manage their potassium [5].
QWhat do people with kidney disease need to know their potassium levels?
A: There are many reasons for the production of high potassium. One of the most common causes is chronic kidney disease. Excess potassium in the body is usually excreted through the kidneys. If the kidneys are not working properly, potassium concentrations can rise to dangerous levels, and patients may be at risk of serious health problems, such as irregular heartbeats, heart attacks, temporary paralysis, and even death.
QWhat are the symptoms of high potassium?
A: Symptoms of high potassium may be vague or mild. Hyperkalemia is usually found on daily blood tests. Signs and symptoms of hyperkalemia may include weakness, fatigue, tingling or numbness, irregular heartbeat, difficulty breathing, inability to move, nausea and vomiting, among others.
QWhat can people with kidney disease do to lower or control their potassium levels?
A: It is important for people with chronic kidney disease to discuss with their health care team how to limit their potassium intake. Dialysis patients should receive all treatments and dialysis to help prevent high potassium. Learn which foods are high in potassium (such as bananas and avocados) and which are low in potassium (such as apples and green beans). Ask your doctor what medications might affect your potassium levels and whether you need them to help lower or manage your potassium levels.
When buying food, it is important to read food nutrition labels carefully. For people on special diets, the above labels can help identify certain nutrients in foods. Although lowering sodium intake is extremely important for people with kidney disease, be cautious about using salt substitutes, including low-sodium packaged foods, as many of them contain potassium.
Conclusion
Today, for the first time in mainland China, Hyperkalemia Awareness Day was also held. Like the U.S. population, the Chinese population is also at risk of hyperkalemia, calling for more attention to hyperkalemia, through simple blood tests for high-risk patients, timely consultation with doctors and active intervention. Let's work together!
Bibliography:
1. Expert Group of Chinese Society of Nephrology. Chinese Journal of Nephrology, 2020, 36(10): 781-792.
2.Bian JM, Zuo L, Zhao HY, et al.. Nephrol Dial Transplant, 2020, 35 Suppl3:iii1127.
3.Kashihara N, Kohsaka S, Kanda E, et al.. Kidney Int Rep, 2019, 4(9): 1248⁃1260. DOI: 10.1016/j.ekir. 2019.05.018.
4.Thomsen RW, Nicolaisen SK, Hasvold P, et al. . Nephrol Dial Transplant,2018, 33(9): 1610⁃1620.
5.https://aakp.org/programs-and-events/national-high-potassium-awareness-day/（2024.4.11检索）
Disclaimer: For the information of healthcare professionals only, not to be forwarded or shared by non-healthcare professionals. Not to be used for promotional purposes. This article was written/published with support from AstraZeneca. Approval number: CN-133754, expiration date: 2025-04-18