Association between annual variability of potassium levels and prognosis in patients undergoing hemodialysis

Seasonal variation of serum potassium in hemodialysis patients: myth or reality? A narrative review of literature

“…A recent retrospective study examining the correlation between variability in serum potassium levels and mortality among hemodialysis patients in Japan also identified seasonal variation in potassium levels, revealing increases during the winter season and reduced levels during the summer season. Considering the study was conducted in Nagasaki Prefecture, a renowned orange producer, there is a likelihood that patients undergoing dialysis have ample opportunities to consume oranges throughout the winter months, thereby potentially augmenting their serum potassium levels [ 32 ]. Furthermore, it is consistent with Shahar et al.…”

“…and Yamaguchi et al. [ 5 , 32 ] reported that potassium levels in Japanese hemodialysis patients peaked in winter and troughed in summer; a recent multicenter cohort study of seasonal variation in serum potassium levels in hemodialysis patients was conducted in Korea [ 35 ] and found that patients in the moderate potassium group(K+, 4.7 ± 0.4 mmol/L) peaked in January and those in the high group(K+, 5.6 ± 0.4 mmol/L) peaked in August. Whereas two studies [ 40 , 41 ] conducted in the Mediterranean region consistently demonstrated that summer is the season when hyperkalemia is more prevalent and severe, contrary to the findings of Cheung, Usvyat, Yanai et al.…”

“…Yamaguchi et al. [ 32 ] demonstrated that serum potassium level fluctuation is associated with prognosis, even after correcting for confounding factors such as age and dialysis duration, and that changes in serum potassium levels are more detrimental than high serum potassium levels. The study found that the relative risk of death in the group with higher coefficient of variation of potassium level was higher than that in the group with lower coefficient of variation of potassium level (RR 1.98, 95% Cl 1.19–3.29, p = .01).…”

Effect of banana intake on serum potassium level in patients undergoing maintenance hemodialysis: A randomized controlled trial

“…Up to 70% of patients undergoing MHD have arrhythmias during hemodialysis, as indicated by wearable defibrillators [ 8 ]. Therefore, excessive fluctuations in the serum potassium level and hypokalemia during hemodialysis are important causes of arrhythmia and even sudden death in these patients [ 9 ]. Avoiding hypokalemia and excessive fluctuation of the serum potassium level during hemodialysis is critical to the stability of the vital signs of patients during hemodialysis and is an important clinical issue that should be addressed.…”