Association between annual variability of potassium levels and prognosis in patients undergoing hemodialysis.

Autor: Yamaguchi K; Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.; Nagasaki Renal Center, Nagasaki, Japan., Kitamura M; Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. mineaki82@yahoo.co.jp.; Nagasaki Renal Center, Nagasaki, Japan. mineaki82@yahoo.co.jp., Otsuka E; Nagasaki Renal Center, Nagasaki, Japan., Notomi S; Nagasaki Renal Center, Nagasaki, Japan., Funakoshi S; Nagasaki Renal Center, Nagasaki, Japan., Mukae H; Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan., Nishino T; Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Jazyk: angličtina
Zdroj: Clinical and experimental nephrology [Clin Exp Nephrol] 2023 Oct; Vol. 27 (10), pp. 873-881. Date of Electronic Publication: 2023 Jun 15.
DOI: 10.1007/s10157-023-02368-4
Abstrakt: Background: Hyperkalemia and hypokalemia are associated with mortality in patients undergoing hemodialysis. However, there are few reports on the association between potassium level fluctuations and mortality. We retrospectively investigated the association between serum potassium level variability and mortality in patients undergoing hemodialysis.
Methods: This study was conducted at a single center. Variability in serum potassium levels was evaluated using the standard deviation of potassium level from July 2011 to June 2012, and its association with prognosis was examined by following up the patients for 5 years. Serum potassium variability was assessed as the coefficient of variation, and the statistical analysis was performed after log transformation.
Results: Among 302 patients (mean age 64.9 ± 13.3; 57.9% male; and median dialysis vintage 70.5 months [interquartile range, IQR 34-138.3]), 135 died during the observation period (median observation period 5.0 years [2.3-5.0]). Although the mean potassium level was not associated with prognosis, serum potassium level variability was associated with prognosis, even after adjustments for confounding factors such as age and dialysis time (hazard ratio: 6.93, 95% confidence interval [Cl] 1.98-25.00, p = 0.001). After the adjustments, the coefficient of variation of potassium level in the highest tertile (T3) showed a higher relative risk for prognosis than that in T1 (relative risk: 1.98, 95% CI 1.19-3.29, p = 0.01).
Conclusions: Variability in serum potassium levels was associated with mortality in patients undergoing hemodialysis. Careful monitoring of potassium levels and their fluctuations is necessary for this patient population.
(© 2023. The Author(s), under exclusive licence to The Japanese Society of Nephrology.)
Databáze: MEDLINE
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