Novel Approaches to the Emergency Management of Hyperkalaemia
type: CreativeWork
description: Hyperkalaemia is the term used to describe raised potassium level in the blood and, if severe, can constitute a medical emergency. Prevalence estimates have historically varied greatly depending on the population investigated with reports ranging from 1-10% in patients admitted to hospital. Management of severe hyperkalaemia (serum potassium >6.5 mmol/L) is typically undertaken in hospital with the use of intravenous insulin and dextrose as first line treatment, which requires regular monitoring, often requires repeat dosing and can expose patients to additional risk, morbidity and a prolonged length of hospital stay. Thus, there is an unmet need to develop a treatment regimen that both acts quickly and specifically enough to be of use in the acute setting but also which is safe and well-tolerated by patients. This thesis investigates the epidemiology and management of hyperkalaemia and explores clinical outcomes associated with hyperkalaemia with a view to enhancing the design of hyperkalaemia management trials by identifying clinically meaningful endpoints. This thesis was undertaken during the COVID-19 pandemic, which caused wide-spread disruption to non-COVID related research, and as a result also includes my work on the design and execution of the COVID-19 prophylaxis trial PROTECT-V. To improve understanding of the prevalence of hyperkalaemia we conducted the first systematic review (chapter two) of all reported observational studies describing the prevalence and/or incidence of hyperkalaemia. This work has provided a comprehensive published review on the prevalence and incidence of hyperkalaemia across a large number of relevant sub-groups and clarifies our understanding of risk-factors for developing hyperkalaemia. Pooled mean hyperkalaemia prevalence was 1.3% amongst the general population, 8.7% amongst adult inpatients and up to 20.7% in patients requiring renal replacement therapy. Another sub-group at risk of hyperkalaemia are users of medications that i…
abstract: Hyperkalaemia is the term used to describe raised potassium level in the blood and, if severe, can constitute a medical emergency. Prevalence estimates have historically varied greatly depending on the population investigated with reports ranging from 1-10% in patients admitted to hospital. Management of severe hyperkalaemia (serum potassium >6.5 mmol/L) is typically undertaken in hospital with the use of intravenous insulin and dextrose as first line treatment, which requires regular monitoring, often requires repeat dosing and can expose patients to additional risk, morbidity and a prolonged length of hospital stay. Thus, there is an unmet need to develop a treatment regimen that both acts quickly and specifically enough to be of use in the acute setting but also which is safe and well-tolerated by patients. This thesis investigates the epidemiology and management of hyperkalaemia and explores clinical outcomes associated with hyperkalaemia with a view to enhancing the design of hyperkalaemia management trials by identifying clinically meaningful endpoints. This thesis was undertaken during the COVID-19 pandemic, which caused wide-spread disruption to non-COVID related research, and as a result also includes my work on the design and execution of the COVID-19 prophylaxis trial PROTECT-V. To improve understanding of the prevalence of hyperkalaemia we conducted the first systematic review (chapter two) of all reported observational studies describing the prevalence and/or incidence of hyperkalaemia. This work has provided a comprehensive published review on the prevalence and incidence of hyperkalaemia across a large number of relevant sub-groups and clarifies our understanding of risk-factors for developing hyperkalaemia. Pooled mean hyperkalaemia prevalence was 1.3% amongst the general population, 8.7% amongst adult inpatients and up to 20.7% in patients requiring renal replacement therapy. Another sub-group at risk of hyperkalaemia are users of medications that i…
author: Humphrey, Toby
language: eng
keywords: Clinical Trials, Epidemiology, Hyperkalaemia, Hyperkalemia, Insulin, Potassium
license: https://www.repository.cam.ac.uk/bitstreams/7a2b8d4a-543f-42bb-80e5-6417ebd5b38c/download
license: https://www.rioxx.net/licenses/all-rights-reserved/
date published: 2023-01-29
date modified: 2026-07-24T01:33:08Z
provider: Cambridge University
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: University of Cambridge

PropertyValue
property ID: DOI
value: 10.17863/CAM.99742