1.
PREVALENCE OF HYPERKALAEMIA, ITS ASSOCIATED
FACTORS AND ELECTROCARDIOGRAPHIC (ECG)
CHANGES AMONG OUTPATIENT NON DIALYSIS
CHRONIC KIDNEY DISEASE PATIENTS IN BMC
AUTHOR: DR. ALPHONCE NGERECHA (MD)

2.
INTRODUCTION
• Hyperkalemia (Serum Potassium >5.5mmol/L) is the
commonest and life-threatening electrolyte abnormality
among patients with CKD (1) (2).
• Prevalence increases in more advanced CKD stages
• Increased serum potassium is associated with a greater
mortality and higher risk of end-stage renal disease
(ESRD). (3)
• It evidenced that new onset and persistent
hyperkalaemia predicts higher ESRD risk VS
normokalaemic CKD patients, independently from main
determinants including eGFR change. (4)

3.
INTRODUCTION…
• Clinical manifestation of hyperkalaemia in CKD are non-
specific ranging from asymptomatic
• ECG changes are valuable diagnostic clues for
recognizing and severity classification of hyperkalaemia
in CKD
• Mild-to-moderate hyperkalaemia status in CKD as
common as (37%) and severe forms as higher as 14%.
(4)

4.
PROBLEM STATEMENT and RATIONALE
• CKD: Associated with significant electrolyte imbalances
• Hyperkalaemia: Most important  Potential risk of arrhythmias
associated with adverse cardiac outcomes, increase risk to ESRD
and mortality rates
• Early recognition, severity classification and intervention is
paramount to delay ESRD: Harder in black race (tolerance
• Depends on the frequency of potassium monitoring and/or ECG
changes
• Current practice: 3 monthly electrolyte estimation
• The study will increase the awareness for potassium monitoring
among CKD patients along with ECG tracing
• Will provide baseline data

5.
OBJECTIVES
GENERAL OBJECTIVE
• To determine the prevalence of hyperkalaemia, its
associated factors and ECG changes among non-dialysis
CKD patients attending Bugando Medical Centre, Mwanza
SPECIFIC OBJECTIVES
1. To determine the magnitude of hyperkalaemia among non-dialysis
CKD patients attending BMC MOPD clinics
2. To determine factors associated with hyperkalaemia among non-
dialysis CKD patients attending attending BMC MOPD clinics
3. To determine ECG changes in patients with hyperkalaemia among
non-dialysis CKD patients attending attending BMC MOPD clinics

6.
METHOLOGY
• Design: Cross sectional study
• Setting: BMC MOPD clinics
• Inclusion criteria:
• 18 years and above with CKD (defined by at least two
consecutive outpatient creatinine measurements >3 months
indicating an eGFR <60 mL/min/1.73m2 (KDIGO)
• Exclusion criteria:
• Patients with established diagnosis hemolytic anaemia
(primary or secondary)
• Sample size:
• Estimated minimum sample size of 237 patients (Leslie and
Kish, P = 47%) Trevisan et al, 2022

7.
METHODOLOGY…
• Dependent variables: Hyperkalaemia, EKG Changes
• Independent variables:
• Demographic data, serum potassium levels, ECG findings
(intraventricular conduction, morphological changes and QRS
complexes), Vital signs and clinical findings during EKG tracing,
current patient diagnoses, current medication, co morbid
conditions
• Study procedures:
• Recruited patients will be subjected to RESTING 12 LEAD ECG
followed by blood sample collection for laboratory serum
potassium estimation. Precautions for pseudo hyperkalemia will
be observed. Other patients’ information will be obtained by
structured questionnaire

8.
ACKNOWLEDGEMENT
• SUPERVISORS: DRS EVA MUJUNI AND LADIUS RUDOVICK
• DRS: SAID KANENDA AND ERNEST E. MREMA