Hyperkalemia in chronic peritoneal dialysis patients
Background. Chronic peritoneal dialysis (PD) patients often develop hypokalemia but less commonly hyperkalemia. Methods. We explored incidence and mechanisms of hyperkalemia in 779 serum samples from 33 patients on PD for 1 − 59 months. Normal serum potassium concentration was defined as 3.5 − 5.1 m...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Renal Failure |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/0886022X.2022.2032151 |
| _version_ | 1818320761545293824 |
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| author | Andrew B. Elliott Karim M. M. Soliman Michael E. Ullian |
| author_facet | Andrew B. Elliott Karim M. M. Soliman Michael E. Ullian |
| author_sort | Andrew B. Elliott |
| collection | DOAJ |
| description | Background. Chronic peritoneal dialysis (PD) patients often develop hypokalemia but less commonly hyperkalemia. Methods. We explored incidence and mechanisms of hyperkalemia in 779 serum samples from 33 patients on PD for 1 − 59 months. Normal serum potassium concentration was defined as 3.5 − 5.1 meq/l. Results. Mean monthly serum potassium concentrations were normal (except for 1 month), but we observed hypokalemia (<3.5 meq/l) in 5% and hyperkalemia (>5.1 meq/l) in 14% of 779 serum samples. Incidence of hyperkalemia did not change over time on PD: Year 1 (15%), Year 2 (11%), Year 3 (19%), Years 4–5 (22%). Hyperkalemia was mostly modest but occasionally extreme [5.2–5.4 meq/l (55%), 5.5–5.7 meq/l (21%), 5.8–6.0 meq/l (10%), >6.0 meq/l (14%)]. Of 31 patients (2 excluded due to brief PD time), 39% displayed hyperkalemia only, 23% displayed hypokalemia only, and the remainder (38%) displayed both or neither. Comparing hypokalemia-only with hyperkalemia-only patients, we found no difference in potassium chloride therapy, medications interrupting the renin-angiotensin system, small-molecule transport status, and renal urea clearance. We compared biochemical parameters from the hypokalemic and hyperkalemic serum samples and observed lower bicarbonate concentrations, higher creatinine concentrations, and higher urea nitrogen concentrations in the hyperkalemic samples (p < 0.001 for each), without difference in glucose concentrations. Conclusion. We observed hyperkalemia 3 times as frequently as hypokalemia in our PD population. High-potassium diet, PD noncompliance, increased muscle mass, potassium shifts, and/or the daytime period without PD might contribute to hyperkalemia. |
| first_indexed | 2024-12-13T10:30:09Z |
| format | Article |
| id | doaj.art-51a280837a0e4df6ac8372eef37c6a91 |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-12-13T10:30:09Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-51a280837a0e4df6ac8372eef37c6a912022-12-21T23:50:53ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492022-12-0144121722310.1080/0886022X.2022.20321512032151Hyperkalemia in chronic peritoneal dialysis patientsAndrew B. Elliott0Karim M. M. Soliman1Michael E. Ullian2Division of Nephrology, Department of Medicine, Medical University of South CarolinaDivision of Nephrology, Department of Medicine, Medical University of South CarolinaDivision of Nephrology, Department of Medicine, Medical University of South CarolinaBackground. Chronic peritoneal dialysis (PD) patients often develop hypokalemia but less commonly hyperkalemia. Methods. We explored incidence and mechanisms of hyperkalemia in 779 serum samples from 33 patients on PD for 1 − 59 months. Normal serum potassium concentration was defined as 3.5 − 5.1 meq/l. Results. Mean monthly serum potassium concentrations were normal (except for 1 month), but we observed hypokalemia (<3.5 meq/l) in 5% and hyperkalemia (>5.1 meq/l) in 14% of 779 serum samples. Incidence of hyperkalemia did not change over time on PD: Year 1 (15%), Year 2 (11%), Year 3 (19%), Years 4–5 (22%). Hyperkalemia was mostly modest but occasionally extreme [5.2–5.4 meq/l (55%), 5.5–5.7 meq/l (21%), 5.8–6.0 meq/l (10%), >6.0 meq/l (14%)]. Of 31 patients (2 excluded due to brief PD time), 39% displayed hyperkalemia only, 23% displayed hypokalemia only, and the remainder (38%) displayed both or neither. Comparing hypokalemia-only with hyperkalemia-only patients, we found no difference in potassium chloride therapy, medications interrupting the renin-angiotensin system, small-molecule transport status, and renal urea clearance. We compared biochemical parameters from the hypokalemic and hyperkalemic serum samples and observed lower bicarbonate concentrations, higher creatinine concentrations, and higher urea nitrogen concentrations in the hyperkalemic samples (p < 0.001 for each), without difference in glucose concentrations. Conclusion. We observed hyperkalemia 3 times as frequently as hypokalemia in our PD population. High-potassium diet, PD noncompliance, increased muscle mass, potassium shifts, and/or the daytime period without PD might contribute to hyperkalemia.http://dx.doi.org/10.1080/0886022X.2022.2032151peritoneal dialysishyperkalemiahypokalemia |
| spellingShingle | Andrew B. Elliott Karim M. M. Soliman Michael E. Ullian Hyperkalemia in chronic peritoneal dialysis patients Renal Failure peritoneal dialysis hyperkalemia hypokalemia |
| title | Hyperkalemia in chronic peritoneal dialysis patients |
| title_full | Hyperkalemia in chronic peritoneal dialysis patients |
| title_fullStr | Hyperkalemia in chronic peritoneal dialysis patients |
| title_full_unstemmed | Hyperkalemia in chronic peritoneal dialysis patients |
| title_short | Hyperkalemia in chronic peritoneal dialysis patients |
| title_sort | hyperkalemia in chronic peritoneal dialysis patients |
| topic | peritoneal dialysis hyperkalemia hypokalemia |
| url | http://dx.doi.org/10.1080/0886022X.2022.2032151 |
| work_keys_str_mv | AT andrewbelliott hyperkalemiainchronicperitonealdialysispatients AT karimmmsoliman hyperkalemiainchronicperitonealdialysispatients AT michaeleullian hyperkalemiainchronicperitonealdialysispatients |