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.
Affiliation
Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan, ROC.
Journal Details
This article was published in the following journal.
Name: Blood purification
ISSN: 1421-9735
Pages: 254-261
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21849775
- DOI: http://dx.doi.org/10.1159/000325226
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.
Hospital Mortality
A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.
Kidney Failure
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.
Hemodialysis, Home
Long-term maintenance hemodialysis in the home.
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