Document Detail

Intestinal bacterial overgrowth in CAPD patients with hypokalaemia.
MedLine Citation:
PMID:  18997162     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We have previously demonstrated that hypokalaemia is a risk factor for enteric peritonitis in CAPD patients. The underlying mechanism is unclear, and there have been no similar reports. We hypothesized that hypokalaemia may result in dysmotility of the intestinal tract and in turn cause bacterial overgrowth and subclinical translocation of enteral bacteria. METHODS: Uraemic patients undergoing CAPD in our hospital were enrolled in the study. Hypokalaemia was defined as a serum potassium (K) level < or = 3.5 mEq/L despite treatment for 1 month. A breath hydrogen test (BHT) was performed to detect if intestinal bacterial overgrowth was present. Blood samples were also collected for the study of inflammatory cytokines, including interleukin 1 (IL1), IL2, IL6, IL8, TNF-alpha and gamma-IFN. RESULTS: A total of 68 patients were recruited. Hypokalaemia was present in 18 cases (26.5%, group 1), while 50 cases (group 2) had normal serum K levels. A higher prevalence of abnormal BHT was found in group 1 (27.8%), compared with group 2 (8.0%, P = 0.048). There was a trend towards a higher prevalence of abnormal BHT in diabetes mellitus (DM) patients with hypokalaemia (80.0%) compared with normal kalaemia (22.2%, P = 0.09), while no similar trends were found in non-DM hypokalaemic patients (7.7 versus 4.9%). When comparisons were made among different subgroups, patients with DM and hypokalaemia had a significantly higher prevalence of abnormal BHT compared to non-DM, normokalaemic patients (P < 0.0004) and non-DM, hypokalaemic patients (P = 0.008). Multivariate logistic regression analysis revealed that DM was an independent risk factor for abnormal BHT (odds ratio: 12.39, 95% CI: 2.25-68.20, P = 0.004). There was no significant difference in serum albumin, Kt/V, weekly creatinine clearance, pattern of peritoneal equilibrium test, C-reactive protein and various inflammatory cytokines between the two groups. CONCLUSION: CAPD patients with hypokalaemia may have intestinal bacterial overgrowth. While both DM and hypokalaemia might contribute to this abnormality, only DM appeared to be the independent risk factor.
Kuo-Hsiung Shu; Chi-Sen Chang; Ya-Wen Chuang; Cheng-Hsu Chen; Chi-Hung Cheng; Ming-Ju Wu; Tung-Min Yu
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-11-07
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  24     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-23     Completed Date:  2009-08-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1289-92     Citation Subset:  IM    
Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
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MeSH Terms
Bacterial Infections / diagnosis*,  etiology
Breath Tests
Diabetes Complications / complications
Hydrogen / analysis
Hypokalemia / complications*
Inflammation / microbiology,  physiopathology
Intestinal Diseases / microbiology*
Intestines / microbiology*
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory
Uremia / complications,  therapy*
Reg. No./Substance:

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