Association of serum potassium level with early and late mortality in very elderly patients with acute kidney injury
Background: The kidneys play a central role in serum potassium (K+) homeostasis, and their dysfunction leads to electrolyte disorders. We aimed to examine the relationship between different levels of K+ and mortality among very elderly patients with acute kidney injury (AKI). Methods: We retrospecti...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Journal of Intensive Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667100X21000505 |
| _version_ | 1818972602830422016 |
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| author | Qinglin Li Yuru Li Feihu Zhou |
| author_facet | Qinglin Li Yuru Li Feihu Zhou |
| author_sort | Qinglin Li |
| collection | DOAJ |
| description | Background: The kidneys play a central role in serum potassium (K+) homeostasis, and their dysfunction leads to electrolyte disorders. We aimed to examine the relationship between different levels of K+ and mortality among very elderly patients with acute kidney injury (AKI). Methods: We retrospectively enrolled very elderly patients (≥75 years) with AKI from the hospital information system of the Chinese PLA General Hospital from January 1, 2007 to December 31, 2018. All-cause mortality was examined according to six predefined K+ levels: <3.50 mmol/L, 3.50–3.79 mmol/L, 3.80–4.09 mmol/L, 4.10–4.79 mmol/L, 4.80–5.49 mmol/L, and ≥5.50 mmol/L. We estimated the risk of all-cause mortality using the multivariable adjusted Cox proportional hazard model with the normal K+ level at 3.50–3.79 mmol/L as a reference. Results: In total, 747 patients were deemed suitable for the final evaluation. The median age of the 747 participants was 88 (84–91) years. After 90 days, the mortality rates in the six strata were 28.3%, 21.9%, 30.1%, 35.4%, 45.2%, and 58.3%, respectively. In the multivariable adjusted analysis, patients with K+ levels of 4.10–4.79 mmol/L (hazard ratio [HR]: 1.638; 95% confidence interval [CI]: 1.016–2.642), 4.80–5.49 mmol/L (HR: 2.585; 95% CI: 1.524–4.384), and ≥5.50 mmol/L (HR: 2.587; 95% CI: 1.495–4.479) had an increased risk of all-cause mortality. After 1 year, the mortality rates in the six strata were 44.8%, 41.1%, 45.1%, 51.8%, 63.1%, and 76.3%, respectively. In the multivariable adjusted analysis, patients with K+ levels of 4.10–4.79 mmol/L (HR: 1.452; 95% CI: 1.014–2.079), 4.80–5.49 mmol/L (HR: 2.151; 95% CI: 1.427–3.241), and ≥5.50 mmol/L (HR: 2.341; 95% CI: 1.514–3.620) had an increased risk of all-cause mortality. Conclusion: Increased serum K+ levels, including levels of 4.10–5.49 mmol/L and ≥5.50 mmol/L, were associated with a significantly increased short- and long-term risk of death. Serum K+ has the potential to be a marker of disease severity among very elderly patients with AKI. |
| first_indexed | 2024-12-20T15:10:53Z |
| format | Article |
| id | doaj.art-ae95d552479b4426a36d05203a2c8752 |
| institution | Directory Open Access Journal |
| issn | 2667-100X |
| language | English |
| last_indexed | 2024-12-20T15:10:53Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Intensive Medicine |
| spelling | doaj.art-ae95d552479b4426a36d05203a2c87522022-12-21T19:36:20ZengElsevierJournal of Intensive Medicine2667-100X2022-01-01215055Association of serum potassium level with early and late mortality in very elderly patients with acute kidney injuryQinglin Li0Yuru Li1Feihu Zhou2Department of Critical Care Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Laboratory Test, The Second Medical Centre, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Critical Care Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China; Chinese PLA General Hospital National Clinical Research Center for Geriatric Diseases, Beijing 100853, China; Corresponding author: Feihu Zhou, Department of Critical Care Medicine, The First Medical centre, Chinese PLA General Hospital, Beijing 100853, China.Background: The kidneys play a central role in serum potassium (K+) homeostasis, and their dysfunction leads to electrolyte disorders. We aimed to examine the relationship between different levels of K+ and mortality among very elderly patients with acute kidney injury (AKI). Methods: We retrospectively enrolled very elderly patients (≥75 years) with AKI from the hospital information system of the Chinese PLA General Hospital from January 1, 2007 to December 31, 2018. All-cause mortality was examined according to six predefined K+ levels: <3.50 mmol/L, 3.50–3.79 mmol/L, 3.80–4.09 mmol/L, 4.10–4.79 mmol/L, 4.80–5.49 mmol/L, and ≥5.50 mmol/L. We estimated the risk of all-cause mortality using the multivariable adjusted Cox proportional hazard model with the normal K+ level at 3.50–3.79 mmol/L as a reference. Results: In total, 747 patients were deemed suitable for the final evaluation. The median age of the 747 participants was 88 (84–91) years. After 90 days, the mortality rates in the six strata were 28.3%, 21.9%, 30.1%, 35.4%, 45.2%, and 58.3%, respectively. In the multivariable adjusted analysis, patients with K+ levels of 4.10–4.79 mmol/L (hazard ratio [HR]: 1.638; 95% confidence interval [CI]: 1.016–2.642), 4.80–5.49 mmol/L (HR: 2.585; 95% CI: 1.524–4.384), and ≥5.50 mmol/L (HR: 2.587; 95% CI: 1.495–4.479) had an increased risk of all-cause mortality. After 1 year, the mortality rates in the six strata were 44.8%, 41.1%, 45.1%, 51.8%, 63.1%, and 76.3%, respectively. In the multivariable adjusted analysis, patients with K+ levels of 4.10–4.79 mmol/L (HR: 1.452; 95% CI: 1.014–2.079), 4.80–5.49 mmol/L (HR: 2.151; 95% CI: 1.427–3.241), and ≥5.50 mmol/L (HR: 2.341; 95% CI: 1.514–3.620) had an increased risk of all-cause mortality. Conclusion: Increased serum K+ levels, including levels of 4.10–5.49 mmol/L and ≥5.50 mmol/L, were associated with a significantly increased short- and long-term risk of death. Serum K+ has the potential to be a marker of disease severity among very elderly patients with AKI.http://www.sciencedirect.com/science/article/pii/S2667100X21000505HyperkalemiaHypokalemiaSerum potassiumAcute kidney injuryElderlyMortality |
| spellingShingle | Qinglin Li Yuru Li Feihu Zhou Association of serum potassium level with early and late mortality in very elderly patients with acute kidney injury Journal of Intensive Medicine Hyperkalemia Hypokalemia Serum potassium Acute kidney injury Elderly Mortality |
| title | Association of serum potassium level with early and late mortality in very elderly patients with acute kidney injury |
| title_full | Association of serum potassium level with early and late mortality in very elderly patients with acute kidney injury |
| title_fullStr | Association of serum potassium level with early and late mortality in very elderly patients with acute kidney injury |
| title_full_unstemmed | Association of serum potassium level with early and late mortality in very elderly patients with acute kidney injury |
| title_short | Association of serum potassium level with early and late mortality in very elderly patients with acute kidney injury |
| title_sort | association of serum potassium level with early and late mortality in very elderly patients with acute kidney injury |
| topic | Hyperkalemia Hypokalemia Serum potassium Acute kidney injury Elderly Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2667100X21000505 |
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