Association of serum potassium with decline in residual kidney function in incident hemodialysis patients.

Abstract

BACKGROUND:

Hyperkalemia is associated with kidney function decline in patients with non-dialysis dependent chronic kidney disease, but this relationship is unclear for residual kidney function (RKF) among hemodialysis (HD) patients.

METHODS:

We conducted a retrospective cohort study of 6655 patients, who started HD January 2007 and December 2011 and who had data on renal urea clearance (KRU). Serum potassium levels were stratified into four groups (i.e. ≤4.0, >4.0 to ≤4.5, >4.5 to ≤5.0 and >5.0 mEq/L) and 1-year KRU slope for each group was estimated by a linear mixed-effects model.

RESULTS:

Higher serum potassium was associated with a greater decline in KRU, and the greatest decrease in KRU (-0.20, 95% confidence interval -0.50 to -0.06) was observed for baseline potassium >5.0 mEq/L in the fully adjusted model. Mediation analysis showed that KRU slope mediated 1.78% of the association between serum potassium and mortality.

CONCLUSIONS:

Hyperkalemia is associated with a decline in RKF amongst incident HD patients. These findings may have important clinical implications in the management of hyperkalemia in advanced CKD if confirmed in additional clinical trials.

• Authors: Yousif Arif, Cachet Wenziger, Jui Ting Hsiung, Amanda Edward, Wei Ling Lau, Ramy M Hanna, Yuji Lee, Yoshitsugu Obi, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Elani Streja
• Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 37 Issue 11 Pg. 2234-2240 (10 19 2022) ISSN: 1460-2385 [Electronic] England
• PMID: 35561740 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural)
• Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.

Chemical References

• Potassium
• Urea

Topics

• Humans
• Kidney Failure, Chronic
• Hyperkalemia (etiology)
• Retrospective Studies
• Renal Dialysis (adverse effects)
• Kidney
• Disease Progression
• Renal Insufficiency, Chronic (complications, therapy)
• Potassium
• Urea