Serum Potassium And Cause-Specific Mortality In A Large Contemporary Peritoneal Dialysis Cohort
Unlike hemodialysis (HD), peritoneal dialysis (PD) is a continuous therapy and does not induce myocardial stunning. However, since the death risk in HD and PD patients is similar we tested the hypothesis that low serum potassium levels contribute more to the high cardiac risk seen with PD resulting...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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The Korean Society of Nephrology
2012-06-01
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| Series: | Kidney Research and Clinical Practice |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211913212005797 |
| _version_ | 1818268450703802368 |
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| author | Klara Torlén Kamyar Kalantar-Zadeh Miklos Z. Molnar Tania Sharma Rajnish Mehrotra |
| author_facet | Klara Torlén Kamyar Kalantar-Zadeh Miklos Z. Molnar Tania Sharma Rajnish Mehrotra |
| author_sort | Klara Torlén |
| collection | DOAJ |
| description | Unlike hemodialysis (HD), peritoneal dialysis (PD) is a continuous therapy and does not induce myocardial stunning. However, since the death risk in HD and PD patients is similar we tested the hypothesis that low serum potassium levels contribute more to the high cardiac risk seen with PD resulting in cardiac risk equivalent to that seen with HD in patients treated in DaVita facilities between 7/1/2001 through 06/30/2006 in the United States (PD, 10,468; HD, 111,651). PD patients were significantly more likely to have serum potassium <4 meq/L (adjusted odds ratio, 3.30 (3.05, 3.56)) than HD patients and there was a U-shaped relationship between time-averaged serum potassium and all-cause and cardiovascular mortality (adjusted hazards ratio for all-cause mortality, potassium <3.5 meq/L, 1.51 (1.29, 1.76); ≥5.5 meq/L, 1.52 (1.32, 1.75)). However, a higher risk for infection-related mortality was seen only with low serum potassium. The population-attributable risks for all-cause mortality for serum potassium <4.0 and ≥5.5 meq/L were 3.6% and 1.9% respectively in PD-treated patients; the corresponding risks in HD patients were 0.8% and 1.5% respectively. Hence, we can conclude that abnormalities in serum potassium – particularly low levels contribute disproportionately to the high death risk both cardiac and non-cardiac in PD patients compared to those treated with HD. Whether aggressive correction of abnormalities in serum potassium levels will reduce death risk is presently not known but seems prudent to pursue.fx1 |
| first_indexed | 2024-12-12T20:38:41Z |
| format | Article |
| id | doaj.art-ea8d38341da940aeb376689c208681d9 |
| institution | Directory Open Access Journal |
| issn | 2211-9132 |
| language | English |
| last_indexed | 2024-12-12T20:38:41Z |
| publishDate | 2012-06-01 |
| publisher | The Korean Society of Nephrology |
| record_format | Article |
| series | Kidney Research and Clinical Practice |
| spelling | doaj.art-ea8d38341da940aeb376689c208681d92022-12-22T00:12:49ZengThe Korean Society of NephrologyKidney Research and Clinical Practice2211-91322012-06-01312A7310.1016/j.krcp.2012.04.546Serum Potassium And Cause-Specific Mortality In A Large Contemporary Peritoneal Dialysis CohortKlara Torlén0Kamyar Kalantar-Zadeh1Miklos Z. Molnar2Tania Sharma3Rajnish Mehrotra4Karolinska Institute, Stockholm, SwedenHarbor-UCLA Med. Cntr, Torrance, CAHarbor-UCLA Med. Cntr, Torrance, CAHarbor-UCLA Med. Cntr, Torrance, CAHarbor-UCLA Med. Cntr, Torrance, CAUnlike hemodialysis (HD), peritoneal dialysis (PD) is a continuous therapy and does not induce myocardial stunning. However, since the death risk in HD and PD patients is similar we tested the hypothesis that low serum potassium levels contribute more to the high cardiac risk seen with PD resulting in cardiac risk equivalent to that seen with HD in patients treated in DaVita facilities between 7/1/2001 through 06/30/2006 in the United States (PD, 10,468; HD, 111,651). PD patients were significantly more likely to have serum potassium <4 meq/L (adjusted odds ratio, 3.30 (3.05, 3.56)) than HD patients and there was a U-shaped relationship between time-averaged serum potassium and all-cause and cardiovascular mortality (adjusted hazards ratio for all-cause mortality, potassium <3.5 meq/L, 1.51 (1.29, 1.76); ≥5.5 meq/L, 1.52 (1.32, 1.75)). However, a higher risk for infection-related mortality was seen only with low serum potassium. The population-attributable risks for all-cause mortality for serum potassium <4.0 and ≥5.5 meq/L were 3.6% and 1.9% respectively in PD-treated patients; the corresponding risks in HD patients were 0.8% and 1.5% respectively. Hence, we can conclude that abnormalities in serum potassium – particularly low levels contribute disproportionately to the high death risk both cardiac and non-cardiac in PD patients compared to those treated with HD. Whether aggressive correction of abnormalities in serum potassium levels will reduce death risk is presently not known but seems prudent to pursue.fx1http://www.sciencedirect.com/science/article/pii/S2211913212005797 |
| spellingShingle | Klara Torlén Kamyar Kalantar-Zadeh Miklos Z. Molnar Tania Sharma Rajnish Mehrotra Serum Potassium And Cause-Specific Mortality In A Large Contemporary Peritoneal Dialysis Cohort Kidney Research and Clinical Practice |
| title | Serum Potassium And Cause-Specific Mortality In A Large Contemporary Peritoneal Dialysis Cohort |
| title_full | Serum Potassium And Cause-Specific Mortality In A Large Contemporary Peritoneal Dialysis Cohort |
| title_fullStr | Serum Potassium And Cause-Specific Mortality In A Large Contemporary Peritoneal Dialysis Cohort |
| title_full_unstemmed | Serum Potassium And Cause-Specific Mortality In A Large Contemporary Peritoneal Dialysis Cohort |
| title_short | Serum Potassium And Cause-Specific Mortality In A Large Contemporary Peritoneal Dialysis Cohort |
| title_sort | serum potassium and cause specific mortality in a large contemporary peritoneal dialysis cohort |
| url | http://www.sciencedirect.com/science/article/pii/S2211913212005797 |
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