#4117 HYPERKALIEMIA TREATMENT APPROACH BY THE NEPHROLOGIST: A REAL-WORLD ANALYSIS (K+RENAL STUDY)

Abstract Background and Aims hyperkaliemia is highly prevalent among chronic kidney disease (CKD) patients its management determinant to allow the maintenance of therapies demonstrated cardiovascular renal benefit. Attitude towards variable different guidelines also clinicians. The aim this study was analyze nephrologist response K serum levels > 5.5 mmol/l in out-patient setting. Method multicentric cross-sectional performed nephrology departments Madrid analyzing therapeutic approach between July 1st December 11th, 2022. only exclusion criteria were being on replacement therapy not obtaining patient's informed consent. Results 13 centers entered including 339 with hyperK; 331 had enough data be included final analysis. 258 (78%) mild hyperK (5.5-5.9), 60 (18.1%) moderate (6.0-6.4) (3.9%) severe (≥6.5). 70.7% males, mean age 72.0 (SD 13.4) 87.3% 55.6% suffered hypertension or DM, respectively. 17.3% diagnosed from heart failure (25% NYHA type I, 63.6% TII 11.4% TIII). Most frequent CKD diagnoses CKD+DM 36%, nephroangioesclerosis/vascular 25.4%, glomerular 7.2% unknown 16.6%. Median eGFG 29.9 ml/min/1.73m2 IQR [21-41] 40.9% UACR 300 mg/g. Distribution according GFR stages homogeneous (Pearson chi2 6.4 p 0.6) Percentage use ACEi, ARBs, MRA NRAi 41.5%, 37.9%, 13.7% 1.52% showed no association higher levels. 33.6% that suffer already any kind low diet, 24.9% K-binding (11.2% calcium polystyrene sulfonate (CPS), 8.2% patiromer 11.2% sodium zirconium cyclosilicate (SZC)). After episode, low-k diet advised 63.9% reinforced 48% diet. Detection followed by initiation k-binding 46.5% (22.8% SZC, 13.2% 10.5% CPS). Treatment ACEi ARBs stopped decreased 17.5% 13% respectively 45% patient MRA, percentage drug discontinuation (40%, 25% 50% respectively) Conclusion clinic suffering are RAASi treatment, more than one third diets almost therapy. Hyperkaliemia dietary advise a high proportion drugs. There still dose decreasing after hyperK, especially episodes