SHM Converge Scientific Abstract ePoster Gallery-Day of Surgery Potassium Testing in End Stage Renal Disease

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This retrospective study examined whether routine day-of-surgery (DOS) potassium testing is useful in patients with end-stage renal disease (ESRD). Using electronic medical record data from an academic medical center, researchers reviewed surgical encounters in adults with ESRD over 10 years, excluding transplant cases. They assessed how often DOS potassium was measured, how often hyperkalemia occurred, and whether abnormal results changed management.<br /><br />Among 4,322 ESRD patients with 13,983 surgical encounters, only 21.5% had a DOS potassium level checked. Of those tested, hyperkalemia (potassium >5.5 mEq/L) was uncommon, occurring in 4.13%. Patients with hyperkalemia were more likely to have lower eGFR, higher ASA class, hypertension, diabetes, and congestive heart failure. Use of chronic potassium-binding medications and angiotensin receptor blockers was also associated with hyperkalemia.<br /><br />Despite these differences, hyperkalemia did not lead to more same-day surgical cancellations or significant delays. However, patients with elevated potassium were more likely to receive treatment on the day of surgery, including insulin/dextrose, calcium gluconate, sodium bicarbonate, albuterol, and potassium-binding medications.<br /><br />The study suggests that while DOS potassium abnormalities are infrequent in ESRD patients, testing may still be valuable in selected higher-risk patients, particularly those with poorer renal function and cardiovascular/metabolic comorbidities. These findings may help clinicians decide when DOS potassium measurement is most appropriate rather than using it universally.

Asset Subtitle

Janessa Snippen

Meta Tag

Author List Abigail Thorgerson, Aprill Dawson, Barbara Slawski, Janessa Snippen

Category Research

Concept Potassium Test

Concept End-stage Kidney Disease

Concept Hyperkalemia

Concept Surgery

Concept Estimated Glomerular Filtration Rate

Distinguished Non-Finalist

Presenter Organization Medical College of Wisconsin

Presenting Author Janessa Snippen

Track Perioperative

Keywords

end-stage renal disease

day-of-surgery potassium

hyperkalemia

retrospective study

electronic medical record

surgical encounters

potassium testing

perioperative management

renal function

surgery cancellation

Potassium Test

End-stage Kidney Disease

Hyperkalemia

Surgery

Estimated Glomerular Filtration Rate