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Background. Post-intubation cicatricial laryngeal stenosis (PICLS) represents one of the most severe long-term complications of pediatric airway management. By systematically analyzing clinical and procedural variables across different grades of PICLS, this study addresses a critical gap in pediatric airway research and provides clinically relevant descriptive data on stenosis severity. Materials and methods. A retrospective single-center case-series study was conducted and included pediatric patients (0–18 years) treated for PICLS at a tertiary referral pediatric otolaryngology center between 2016 and 2024. Spearman correlation and multiple regression analyses were used to evaluate possible associations between clinical factors and stenosis grade. Results. Among 172 children with PICLS, severe forms of stenosis (Grades 3–4) were observed in 37.2%, with predominant subglottic localization (85.3%). Age at primary intubation (p = 0.02) and the type of intubation (emergency/elective; p = 0.04) were the only variables significantly associated with stenosis severity in this cohort, whereas sex, reintubation, comorbidities, and delivery-related factors showed no significant associations. Mild stenosis (Grades 1–2) more frequently followed intubation for elective surgery and infections, whereas severe stenosis was more commonly associated with intubation due to central nervous system pathology and infections. Conclusions. Age at primary intubation and the type of intubation (emergency/elective) were associated with stenosis severity in this cohort. These findings should be interpreted in light of the retrospective case-series design and the absence of a control group, but they may contribute to improved clinical characterization of PICLS severity in children. Full article

Background: Sézary syndrome (SS) is an aggressive leukemic variant of cutaneous T-cell lymphoma (CTCL) with distinct clinical and biological features compared to rarer entities such as primary cutaneous CD8⁺ aggressive epidermotropic cytotoxic T-cell lymphoma (PCAECTCL). Although recurrent genomic alterations in CTCL have been described, comparative analyses at the pathway level across biologically divergent subtypes remain limited. Here, we leveraged a conversational artificial intelligence (AI) platform for precision oncology to enable rapid, integrative, and hypothesis-driven interrogation of publicly available genomic datasets. Methods: We conducted a secondary analysis of somatic mutation and clinical data from the Columbia University CTCL cohort accessed via cBioPortal. Cases were stratified into SS (n = 26) and PCAECTCL (n = 13). High-confidence coding variants were curated and mapped to biologically relevant signaling pathways and functional gene categories implicated in CTCL pathogenesis. Pathway-level mutation frequencies were compared using Fisher’s exact tests, with effect sizes quantified as odds ratios. Tumor mutational burden (TMB) was compared using the Wilcoxon rank-sum test. Subtype-specific co-mutation patterns were evaluated using pairwise association analyses and visualized through oncoplots and network heatmaps. A conversational AI agent, AI-HOPE, was used to iteratively refine cohort definitions, prioritize pathway-level signals, and contextualize findings. Results: TMB was comparable between SS and PCAECTCL (p = 0.96), indicating no significant difference in global mutational load. In contrast, pathway-centric analyses revealed marked qualitative differences. SS demonstrated enrichment of alterations in epigenetic regulators, tumor suppressor and cell-cycle control pathways, NFAT signaling, and DNA damage response mechanisms, consistent with transcriptional dysregulation and immune modulation. PCAECTCL exhibited relatively higher frequencies of alterations involving epigenetic regulators and MAPK pathway signaling, suggesting distinct oncogenic dependencies. Co-mutation analysis revealed a more constrained and focused interaction landscape in SS, whereas PCAECTCL displayed broader and more heterogeneous co-mutation networks, indicative of divergent evolutionary trajectories. Notably, ERBB2 mutations were significantly enriched between subtypes (p = 0.031), highlighting a potential subtype-specific therapeutic vulnerability. Conclusions: This study demonstrates that SS is distinguished from PCAECTCL not by increased mutational burden but by distinct pathway-level architectures, particularly involving epigenetic regulation, immune signaling, and transcriptional control. These findings generate biologically grounded, testable hypotheses for subtype-specific therapeutic targeting and underscore the value of conversational AI as a scalable framework for accelerating discovery in translational cancer genomics. Full article

Background: Accurate knowledge of the pterygopalatine fossa (PPF) and the greater palatine canal/foramen (GPC/GPF) is clinically important for administering anesthesia through the canals and for planning surgical access to the posterior maxilla. Cone-beam computed tomography (CBCT) enables evaluation of anatomic structures of interest in individual patients when two-dimensional imaging methods are inadequate. Methods: This cross-sectional study retrospectively analyzed 150 CBCT datasets from residents of Abha city in the Asir region of Saudi Arabia who visited a dental hospital from November 2025 to February 2026; of these, 65 datasets were included. Bilateral measurements of the PPF-GPC complex and the anteroposterior (AP) position of the GPF were taken; subject-level means were used to avoid non-independence. Multivariate models adjusted for age and sex were fitted. Curvature was assessed using a cluster logistic model. Results: The mean length of the PPF-GPC complex was 33.12 ± 3.07 mm (P5-P95 interval, 28.91–39.50). After adjusting for age and sex, males had a longer pathway (+2.25 mm; 95% confidence interval [CI], 0.35–4.15; p = 0.020); pathway length decreased slightly with increasing age (−0.38 mm per decade; 95% CI, −0.73 to −0.03; p = 0.034). The mean distance from the ANS to the GPF was 47.28 ± 3.58 mm and increased with age by 0.67 mm per decade (95% CI, 0.23–1.11; p = 0.003). Curved canals accounted for 56.2% of the sides examined. No significant association was observed between sex and either curvature status or side. Conclusions: In this population, the length of the pathway from the palate to the PPF and the AP location of the GPF showed clinically relevant variations among individuals. Adjusted estimates indicated that sex and age can predictably influence the length of the pathway and the distance of the GPF from the ANS, supporting the use of patient-specific CBCT evaluations to identify landmarks for anesthesia through the canals or when planning posterior maxillary surgical procedures. Full article

Endometriosis is a chronic inflammatory disease in which transforming growth factor-beta (TGF-β) has been implicated in immune dysregulation, extracellular matrix remodeling, and fibrosis. Data on baseline secretion of TGF-β isoforms by systemic immune cells remain limited. This pilot study quantified unstimulated secretion of TGF-β1, TGF-β2, and TGF-β3 by peripheral blood mononuclear cell (PBMC) cultures from women with and without endometriosis and explored stage-related patterns. In this prospective case–control study, PBMCs from 50 women with surgically confirmed endometriosis and 30 controls were cultured for 24 h without exogenous stimulation. Supernatant concentrations were measured using a multiplex bead-based immunoassay (Bio-Plex, Bio-Rad) and expressed as pg/mL; between-group and stage-related differences were assessed using non-parametric tests. Median 24 h secretion was similar between groups (TGF-β1: 103,816 vs. 114,700 pg/mL, p = 0.25; TGF-β2: 3735 vs. 3732 pg/mL, p = 0.32; TGF-β3: 3280 vs. 3284 pg/mL, p = 0.70). Within the endometriosis cohort, TGF-β2 was significantly higher in moderate/advanced disease (rASRM stages III–IV) than in minimal/mild disease (stages I–II), whereas TGF-β1 and TGF-β3 did not reach statistical significance for a stage-dependent pattern in this pilot cohort (p = 0.42 and p = 0.41, respectively; Kruskal–Wallis), and a type II error cannot be excluded given the small sample size per rASRM (revised American Society of Reproductive Medicine)stage (n = 11–14). These findings suggest that TGF-β dysregulation is compartmentalized to the peritoneal environment rather than systemically imprinted in circulating immune cells. The stage-dependent elevation of TGF-β2 supports its role in progressive fibrogenesis and as a candidate severity biomarker, warranting confirmation in larger, stimulus-augmented studies. Full article

Background: The risk stratification of unruptured intracranial aneurysms (UIAs) relies largely on static clinical and morphological parameters, which may not fully capture aneurysm-specific wall behavior. ECG-gated four-dimensional computed tomography angiography (4D-CTA) enables the time-resolved assessment of aneurysm wall motion, but reliable interpretation requires the differentiation of biological motion from measurement uncertainty. Methods: In this prospective exploratory pilot study, ECG-gated 4D-CTA was used to evaluate the longitudinal aneurysm size change, global volumetric pulsation (GVP), spatial wall pulsation (SWP), intrinsic wall deformability and variability. Size change and pulsation were defined using predefined resolution- and noise-based thresholds. Spatial wall motion was assessed using phase-resolved three-dimensional displacement maps. Harmonic modeling isolated periodic pulsation, and residual variability exceeding empirically derived uncertainty limits was conservatively interpreted as deformability. Associations with aneurysm growth and ELAPSS scores were analyzed using exploratory statistics. Results: Eleven UIAs in ten patients were followed for 4.3 ± 1.1 years. A longitudinal size change occurred in six aneurysms (54.5%). Baseline GVP was present in eight aneurysms (73%) and SWP in nine (82%). GVP was not associated with a size change (p = 1.00). All aneurysms with a size change exhibited baseline SWP, whereas no size change was observed in aneurysms without SWP; however, this association did not reach statistical significance in this small exploratory cohort (p = 0.18). Conservative variability metrics were not associated with growth but correlated with baseline shape irregularity, particularly the undulation index (Spearman’s ρ up to ~0.90). Conclusions: In this small exploratory pilot cohort, spatial wall pulsation showed a descriptive directional pattern with longitudinal aneurysm size changes, whereas global volumetric pulsation did not. These findings are preliminary, should be interpreted cautiously, and require confirmation in larger, adequately powered longitudinal studies before clinical application. Full article

Background: Among the complications caused directly or indirectly by the Human Immunodeficiency Virus (HIV) are alterations in the auditory system. Children who are HIV-exposed but uninfected (HEU) appear to have a higher risk of hearing loss (HL) compared to their unexposed peers, but a lower risk than those infected with HIV. However, the literature remains inconclusive regarding this association. This study aims to evaluate the hearing function of HEU infants during the first months of life and to correlate these findings with maternal, gestational, and neonatal variables. Methods: This prospective cohort study included all HIV-exposed infants born in a quaternary hospital in southern Brazil between 2021 and 2023. Maternal, gestational, and neonatal data were collected, as well as the results of neonatal auditory screening. At approximately 6 months of age, otolaryngological and audiological assessments were performed, including wideband tympanometry and electrophysiological evaluation using Auditory Brainstem Response with frequency-specific stimuli. The prevalence of hearing loss refers to the number of infants affected. Results: Thirty-eight infants, with a mean age of 8 months (±3.3), completed the study. Of these, 1 (2.6%) presented with bilateral sensorineural HL, and 13 (34.2%) presented with conductive HL, with 6 cases being unilateral and 7 bilateral. No associations were found between hearing loss and maternal, gestational, or neonatal variables, except for maternal CD4 count, where higher CD4 cell counts were associated with an increased risk of conductive HL. Conclusion: The findings provide relevant data on auditory alterations in HEU infants, demonstrating a high prevalence of conductive HL. These results highlight the importance of monitoring the hearing of these children during the first years of life. Full article

Background and Objectives: Acute cholecystitis is a common indication for emergency surgery. While acute calculous cholecystitis (ACC) is most common, acute acalculous cholecystitis (AAC) occurs without gallstones and is often associated with severe systemic illness. We compared early postoperative outcomes after cholecystectomy for AAC versus ACC, with emphasis on complication severity and overall morbidity burden. Materials and Methods: We performed a single-center retrospective cohort study of consecutive adults undergoing urgent or emergent cholecystectomy for acute cholecystitis between December 2020 and April 2025. Patients with chronic cholecystitis, duplicate records, missing group assignment, or incomplete 30-day follow-up were excluded. The primary 30-day endpoints were postoperative complications, their severity (assessed with Clavien–Dindo scale), and cumulative morbidity assessed using the Comprehensive Complication Index. Secondary outcomes included operative approach, postoperative length of stay, 30-day readmission, and mortality. Results: A total of 221 patients were analyzed (181 ACC, 40 AAC). Patients with AAC were older and more frequently male. Any complication within 30 days occurred substantially more often in AAC patients than in ACC patients. Morbidity severity also differed markedly, with higher-grade complications occurring more frequently in the AAC group. AAC patients exhibited a substantially greater overall morbidity burden, indicating not only more frequent complications but also a heavier cumulative impact. Thirty-day mortality was considerably higher in AAC. Open surgery was more commonly required in AAC, whereas postoperative length of stay and 30-day readmission rates were similar between groups. Conclusions: In this cohort, AAC was associated with substantially worse early outcomes after cholecystectomy than ACC, characterized by a pronounced increase in clinically significant complications (Clavien–Dindo ≥ IIIa), greater cumulative morbidity (CCI), and markedly higher 30-day mortality. These findings support treating AAC as a high-risk phenotype warranting intensified perioperative optimization and vigilant postoperative monitoring. Full article

Background/Objectives: Despite substantial progress in the management of psoriasis, evidence on as-needed dosing strategies for biologic therapies remains scarce. In this context, the present study aimed to assess the effectiveness of a previously defined as-needed bimekizumab (BKZ) dosing regimen in a larger cohort of patients with psoriasis, as well as to identify clinical factors associated with treatment response. Methods: In this retrospective study, medical records of 64 patients with moderate-to-severe psoriasis treated with BKZ between May 2023 and November 2025 at a specialized psoriasis unit in Madrid, Spain, were reviewed. Patients followed an off-label, as-needed dosing regimen, consisting of two initial 320 mg doses at Weeks 0 and 4, with subsequent administrations only upon loss of a PASI 90 response. The primary outcome was the proportion of patients achieving and maintaining optimal disease control (PASI 90) over time. The duration of treatment effect was defined as the interval between the second dose and loss of PASI90 in the absence of further treatment. Safety outcomes were also evaluated. Results: A total of 59 out of 64 patients achieved a PASI 90 response after the initial two BKZ doses, and all maintained disease control with the as-needed dosing strategy over time. On average, patients received approximately one-third of the doses expected under the standard dosing regimen. The mean duration of treatment effect following the second dose was approximately 24 weeks. Systemic and bio-naïve patients presented the longest treatment effect duration under the as-needed dosing regimen. Oral candidiasis was reported in two patients and resolved without complications. Conclusions: This study reinforces previous evidence supporting the effectiveness of an as-needed BKZ dosing strategy, particularly in patients naïve to systemic and biologic therapies for psoriasis. Nevertheless, larger prospective studies are required to confirm these findings. Full article

Background/Objectives: This study aimed to assess complications after endoscopic radial artery harvest, evaluate patient satisfaction, and assess the feasibility of a questionnaire interview. The primary aim was to assess neurological damage after endoscopic radial artery harvest (ERAH), and the secondary aim was to assess the feasibility of a newly constructed questionnaire in Danish. Methods: From June 2010 through October 2012, 108 patients underwent endoscopic radial artery harvest for coronary artery bypass grafting (CABG) at our institution. A total of 100 patients were interviewed by phone between one and two years after the operation. The interviews included questions about infection, bleeding, neurological damage, vascular perfusion of the hand, re-intervention, and general satisfaction with the procedure. Results: The described cohort was mainly male (88.9% 95% confidence interval (CI) 90.5–98.4%) with a mean age of 60.8 years (standard deviation (SD) 9.0). The self-reported incidence of postoperative antibiotic treatment was 7.0% (95% CI 3.1–14.4%), sensory deficit 18.0% (95% CI 11.3–27.2%), pain 8.0% (95% CI 3.8–15.6%), motoric deficit 4.0% (95% CI 1.3–10.5%) and cold or pale fingers 9.0% (95% CI 4.5–16.8%). At a follow-up time with a mean of 1.40 years (range 0.97–2.37 years, SD 0.36), all incisions were healed satisfactorily, 12.0% (95% CI 6.6–20.4%) reported sensory deficit, 7.0% (95% CI 3.1–14.4%) reported pain, 2.0% (95% CI 0.3–7.7%) reported motoric deficit, and none had a tendency towards cold fingers. The mean duration of antibiotic treatment was 8.7 days ± 2.3. When asked to rate the endoscopic procedure points of satisfaction from 0 (worst) to 10 (best), the mean was 9.7 ± 0.7. Conclusions: This study reports the occurrence of surgical complications immediately after ERAH, with an occurrence of self-reported neurological deficits of 18%. A questionnaire was feasible in a cohort of postoperative patients receiving radial artery harvest. Full article

Background: Emergency department evaluation of suspected urolithiasis increasingly relies on non-contrast CT, yet not all patients require imaging. Existing clinical prediction rules help stratify stone probability, but by converting continuous measurements into fixed binary indicators, they offer little insight into why a particular patient is at risk or how much uncertainty remains after each testing stage—questions that bear directly on individualized diagnostic decisions. Methods: We retrospectively analyzed 1000 ED patients with suspected urolithiasis who underwent non-contrast CT (stone prevalence 85.0%). A gradient boosting classifier was trained on 17 continuous clinical and laboratory features and compared against binary-thresholded counterparts and an established scoring system; the 17-feature model achieved AUC 0.771 (95% CI 0.726–0.813) versus 0.723 (95% CI 0.675–0.771) for the reference score on this cohort (DeLong p = 0.001). Individual predictions were explained using an interventional Shapley value approach, and a Shannon entropy-based framework was applied to quantify the marginal diagnostic contribution of each sequential testing stage. Results: Held-out permutation importance identified red blood cell count on microscopy, age, pain duration, and prior stone history as the most influential predictors. Several features showed non-linear contributions that diverged from conventional binary thresholds: creatinine effect crossed zero near 0.90 mg/dL and pain duration peaked between 2 and 5 h. C-reactive protein, absent from existing scoring systems, emerged as a meaningful negative predictor. Sequential entropy analysis showed that dipstick urinalysis provided the largest marginal information gain among non-history stages (6.1% of prior entropy), while physical examination contributed 2.3%. A prevalence sensitivity analysis projected that the framework’s threshold behavior would differ substantially in lower-prevalence populations, underscoring that the cohort-specific cut-points are not portable decision rules. We therefore position the framework as a reasoning aid that complements clinical judgment and imaging, not as a stand-alone triage tool. Conclusions: Explainable machine learning can address questions that aggregate discrimination metrics cannot: which features drive risk for a given patient, how those effects behave across the continuous measurement range, and how much diagnostic uncertainty each testing stage resolves. The Shapley-based explanations and entropy framework developed here offer a structured approach to individualized diagnostic reasoning in the ED evaluation of suspected urolithiasis, functioning as an interpretive adjunct to, rather than a replacement for, existing clinical tools and CT imaging. Full article

Background: Cardiorenal syndrome (CRS) arises from interconnected cardiovascular, renal, and metabolic dysfunction driven by shared risk factors such as hypertension, diabetes, and obesity. Cardiac rehabilitation (CR) is a multidisciplinary intervention; however, its impact on CRS risks remains unclear. Methods: This retrospective cohort study analyzed electronic medical record data from 394 participants enrolled in a three-month CR program. Baseline and post-program measures included functional capacity, cardiometabolic risk factors, and psychosocial outcomes. Results: Participants (mean age 62.44 ± 12.15 years; 66.8% male) had a high burden of CRS risk factors, including hypertension (85.8%), diabetes (60.6%), and obesity (57.8%). Significant improvements were observed in functional capacity (6 min walk distance increased by 213 m, p < 0.001), muscular strength, flexibility, and psychosocial outcomes (anxiety, depression, perceived health; all p < 0.001). In contrast, changes in CRS risk factors were modest: fasting blood glucose decreased slightly (p = 0.043), while HbA1c, body fat, and cholesterol showed no significant change. Systolic blood pressure and body weight increased significantly. Cardiac rehabilitation improves functional and psychosocial outcomes but demonstrates limited short-term impact on CRS risk factors. Conclusions: These findings suggest CR may serve as an initial platform for CRS risk modification but requires integration with comprehensive cardio–renal–metabolic management strategies. Full article

Hepatocellular carcinoma (HCC) is a highly aggressive malignancy with poor prognosis and limited therapeutic options. Although epigenetic dysregulation is a hallmark of HCC, rational combinatorial targeting strategies remain incompletely defined. Here, we identify cooperative oncogenic functions of the chromatin modifiers enhancer of zeste homolog 2 (EZH2) and lysine-specific demethylase 1 (LSD1) in HCC. Analysis of the TCGA-LIHC cohort revealed that co-elevated EZH2 and LSD1 expressions are significantly associated with reduced overall survival. Gene set enrichment analysis demonstrated enrichment of Sonic Hedgehog (SHH) signaling and stress-responsive transcriptional programs in tumors with high EZH2/LSD1 expression. Functionally, dual pharmacological inhibition of EZH2 (GSK126) and LSD1 (SP2509) suppressed HCC cell proliferation, induced G1-phase arrest, and enhanced apoptosis, as evidenced by increased caspase-3/7 activity and decreased pro-caspase levels. Dual inhibition also impaired migration, invasion, tumor sphere formation, and stemness-associated gene expression. Mechanistically, co-targeting disrupted SHH signaling through the suppression of GLI1 expression. Chromatin immunoprecipitation revealed reduced EZH2, LSD1, and STAT3 occupancy at the GLI1 promoter following dual inhibition, leading to the repression of GLI1 and its downstream targets. Collectively, these findings demonstrate that EZH2 and LSD1 cooperatively sustain GLI1-dependent SHH signaling in HCC, and that dual epigenetic inhibition represents a mechanistically defined therapeutic strategy. Full article

Low-risk prostate cancer (PCa) has historically been overtreated, exposing men to unnecessary morbidity. Emerging evidence supports conservative management of low-risk PCa without immediate radical intervention. Contemporary data show a marked decline in surgical overtreatment, with the proportion of radical prostatectomies yielding only Grade Group 1 cancers falling from 32.4% in 2010 to 7.8% in 2020 in the US SEER registry. Long-term studies confirm that deferring treatment is safe for low-risk disease, with PCa-specific survival exceeding 95% at 15–25 years for cohorts managed with surveillance. Major guidelines now endorse active surveillance (AS) as the preferred management for low-risk PCa. An alternative risk stratification system that expands the low-risk category was shown to reclassify 45–83% more men as low risk without increasing 15-year PCa mortality. Focal therapy has emerged as a potential middle-ground strategy, though evidence is still limited. The paradigm for managing low-risk PCa has shifted toward conservatism, with AS firmly established as the standard of care. Continued efforts to refine risk stratification and evaluate focal therapy are needed to further optimize individualized care, minimize harm, and maintain excellent cancer-specific outcomes for low-risk PCa. This comprehensive review aims to create a practical, risk-adapted framework for managing patients on AS. We will: (i) summarize inclusion criteria and outcomes, (i) compare AS follow-up schedules across major institutions and guidelines, (iii) provide evidence-based criteria to de-intensify surveillance in men with sustained stability and (iv) clarify the role of focal therapy as an intermediate treatment option within the AS continuum. Full article

Background: Liver histology remains the gold standard for assessing liver steatosis (LS); however, non-invasive methods are increasingly being explored in clinical practice. This study aimed to evaluate the agreement between magnetic resonance imaging (MRI) and liver histology in quantifying LS in patients with morbid obesity undergoing bariatric surgery (BS). Methods: This ancillary study is part of a prospective, double-blind, multicenter, randomized placebo-controlled trial investigating the effects of preoperative omega-3 polyunsaturated fatty acid supplementation on liver volume in morbidly obese patients undergoing BS. The parent trial yielded negative results, and randomization arm was retained as a covariate in all analyses. Patients underwent MRI within 2 days before surgery, followed by intraoperative wedge resection and TruCore needle liver biopsy. Agreement between MRI and histology was assessed using the intraclass correlation coefficient (ICC) and Cohen’s kappa coefficient (K) for both macro- and microvesicular steatosis. Results: Thirty-seven patients were enrolled; paired MRI and biopsy data were available for thirty-one (83.8%). Moderate and statistically significant agreement was observed between MRI and both TruCore (ICC: 0.52, p = 0.002; K: 0.42, p = 0.007) and wedge-resection (ICC: 0.53, p = 0.001; K: 0.29, p = 0.044) biopsies for macrovesicular steatosis. The MRI-derived values were systematically lower than histological estimates for macrovesicular steatosis (mean MRI: 23.4% vs. histology: 36.7–37.1%). No significant agreement was identified for microvesicular steatosis with either biopsy technique. Conclusions: In morbidly obese patients, MRI demonstrates only moderate agreement with liver histology for macrovesicular steatosis and is unreliable for microvesicular steatosis. The systematic underestimation of macrovesicular steatosis by MRI warrants caution when this modality is used as a standalone decision-making tool in this population. Further studies in larger and more heterogeneous cohorts are needed to better define the performance boundaries of MRI-derived fat-fraction measurement across the spectrum of obesity and metabolic liver disease. Full article

Background/Objectives: Hyperkalemia is common in patients with chronic kidney disease (CKD). However, its epidemiology may be evolving due to population aging, new therapeutic developments and novel estimated glomerular filtration rate (eGFR) equations. We have re-evaluated the epidemiology of hyperkalemia in a contemporary cohort in which eGFR was assessed using the EKFC equation recommended by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM). Methods: We analyzed 190,579 laboratory tests with serum potassium values corresponding to individual outpatients in Primary or Specialty Care from a single laboratory in 2023, representing 42% of the catchment area population. Results: Hypokalemia (<3.5 mmol/L) was present in 0.3% patients, hyperkalemia (≥5.0 mmol/L) in 10.5% (11.5% of men, 9.7% of women). Hyperkalemia was mostly mild (9.4%) but was severe in 0.1% overall and in 10.5% of CKD G5. One in four patients with hyperkalemia had CKD. Hyperkalemia was more common among patients with CKD G3–G5 defined using the CKD-EPI2009 equation than defined using the EKFC equation (20.5 vs. 18.6%, p < 0.0001). Using EKFC, hyperkalemia prevalence increased with decreasing eGFR from G1 (6.6%) to G2 (10.8%) and, especially in CKD G3–G5 (G3 17.2% to G5 47.5%). In multivariate logistic analysis, worse renal function, worse diabetes control, older age, and surrogates for release of intracellular potassium during sample processing (red blood cell counts or size, platelet counts, elevated calcium levels) were independently associated with hyperkalemia. This multivariate model yielded an area under the curve (AUC) of the Receiver Operating Characteristic (ROC) curve for hyperkalemia of 0.678 (95% CI 0.674–0.682). Random forest also identified GFR as the most important feature associated with hyperkalemia and generally concurred with logistic analysis findings. Conclusions: Hyperkalemia remains common, especially in CKD G5. While hyperkalemia is mainly associated with low eGFR, sample processing should be optimized. Full article