Hypokalemia Is Associated with Increased Mortality Rate in Chronic Hemodialysis Patients.
Summary of "Hypokalemia Is Associated with Increased Mortality Rate in Chronic Hemodialysis Patients."
Background: Both hypokalemia (hypoK) and hyperkalemia (hyperK) are life-threatening to hemodialysis (HD) patients. This study was conducted to compare their clinical characteristics and long-term survival. Methods: Patients were divided into three groups according to the last mid-week predialysis serum potassium concentrations: hypoK (<3.5 mEq/l), normoK (between 3.5 and 5.5 mEq/l), and hyperK (>5.5 mEq/l). The maximal duration of the follow-up period was 54 months. Results: Compared with the hyperK group,patients in the hypoK group were older (p <0.05), had a higher incidence of comorbidity factors, less body weight gain prior to HD (p < 0.05), lower body mass index (BMI, p < 0.05), and higher BUN to creatinine ratio and hs-CRP (p < 0.05). The serum albumin and prealbumin concentrations were also lowest in the hypoK group, compared with the normoK and hyperK groups, respectively (all p < 0.001). A similar finding was also obtained for the normalized protein catabolism rate (nPCR, p < 0.001) among the three groups. Positive linear correlations between serum albumin and potassium concentration were only found in the hypoK and normoK groups (p < 0.001). Multiple logistic regression analysis showed that hypoalbuminemia, low BUN, and phosphate concentrations were significantly correlated with hypoK. HypoK patients also had a lower cumulative survival rate than hyperK patients. Conclusion: HypoK HD patients, with lower serum levels of albumin, prealbumin, nPCR, and BMI, but higher level of hs-CRP, showed a malnutritional and inflammatory status, and caused increased mortality rate.
Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan, ROC.
This article was published in the following journal.
Name: Blood purification
Medical and Biotech [MESH] Definitions
Kidney Failure, Chronic
The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.
Hemodialysis Units, Hospital
Hospital units in which care is provided the hemodialysis patient. This includes hemodialysis centers in hospitals.
A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.
A severe irreversible decline in the ability of kidneys to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal failure, either acute (KIDNEY FAILURE, ACUTE) or chronic (KIDNEY FAILURE, CHRONIC), requires HEMODIALYSIS.
Long-term maintenance hemodialysis in the home.
Higher serum alkaline phosphatase predicts lower mortality in chronic kidney disease and hemodialysis patients without liver dysfunction because it reflects high bone turnover. The purpose of our stud...
Limited health literacy is common in the United States and associates with poor clinical outcomes. Little is known about the effect of health literacy in patients with advanced kidney disease. In this...
Cardiovascular disease is the most common cause of mortality in patients with chronic kidney disease on hemodialysis. In addition to a high prevalence of traditional cardiovascular risk factors, other...
Uremic cardiomyopathy is responsible for high morbidity and mortality rates among patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD); however, the early implementation of hem...
OBJECTIVES: The aim of this study was to determine whether telmisartan decreases all-cause and cardiovascular mortality and morbidity in hemodialysis patients with chronic heart failure (CHF) and impa...
The purpose of this study is to compare the effect of low flux hemodialysis with online hemodiafiltration on all cause mortality and a combination of cardiovascular morbidity and mortality...
The purpose of this study is to verify whether pitavastatin prevents from cardiovascular events and improves the mortality in chronic hemodialysis patients with hypercholesteremia.
Randomized controlled trial comparing effects of ergometer exercise during hemodialysis to effects of pedometer use outside of hemodialysis on exercise capacity, functional status, quality...
Patients on hemodialysis will be randomly assigned (1:1) to continue on conventional hemodialysis or on-line hemodiafiltration, both three times per week. A 3 year follow-up and a sample s...
Hemodialysis is a cause of carnitine deficiency. The deficiency of carnitine induces an anemia by an increase fragility of the red blood cells, a muscular fatigue and a cardiac dysfunction...