Document Detail


Association of hypo- and hyperkalemia with disease progression and mortality in males with chronic kidney disease: the role of race.
MedLine Citation:
PMID:  22156587     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Abnormal serum potassium is associated with higher mortality in dialysis patients, but its impact on outcomes in predialysis chronic kidney disease (CKD) is less clear. Furthermore, blacks with normal kidney function have lower urinary potassium excretion, but it is unclear if such differences have a bearing on race-associated outcomes in CKD.
METHODS: We studied predialysis mortality and slopes of estimated glomerular filtration rate, eGFR) associated with serum potassium in 1,227 males with CKD. Mortality was examined in time-dependent Cox models, and slopes of eGFR in linear mixed effects models with adjustments for case mix and laboratory values.
RESULTS: Both hypo- and hyperkalemia were associated with mortality overall and in 933 white patients, but in 294 blacks hypokalemia was a stronger death predictor. Hypokalemia was associated with loss of kidney function independent of race: a 1 mEq/l lower potassium was associated with an adjusted difference in slopes of eGFR of -0.13 ml/min/1.73 m(2)/year (95% CI: -0.20 to -0.07), p < 0.001.
CONCLUSION: Hypo- and hyperkalemia are associated with higher mortality in CKD patients. Blacks appear to better tolerate higher potassium than whites. Hypokalemia is associated with faster CKD progression independent of race. Hyperkalemia management may warrant race-specific consideration, and hypokalemia correction may slow CKD progression.
Authors:
John Hayes; Kamyar Kalantar-Zadeh; Jun L Lu; Sharon Turban; John E Anderson; Csaba P Kovesdy
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2011-12-02
Journal Detail:
Title:  Nephron. Clinical practice     Volume:  120     ISSN:  1660-2110     ISO Abbreviation:  Nephron Clin Pract     Publication Date:  2012  
Date Detail:
Created Date:  2012-04-04     Completed Date:  2012-09-05     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  101159763     Medline TA:  Nephron Clin Pract     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  c8-16     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Affiliation:
Division of Nephrology, University of Virginia, Charlottesville, Va., USA.
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group*
Aged
Aged, 80 and over
Blood Pressure
Body Mass Index
Chronic Disease
Comorbidity
Disease Progression
European Continental Ancestry Group*
Humans
Hyperkalemia / epidemiology,  etiology*
Hypokalemia / epidemiology,  etiology*
Kidney Diseases / blood*,  complications,  ethnology,  mortality
Kidney Function Tests
Male
Middle Aged
Smoking / epidemiology
Virginia / epidemiology
Grant Support
ID/Acronym/Agency:
1R01DK078106-01/DK/NIDDK NIH HHS
Comments/Corrections

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