Serum Potassium and Mortality Risk in Hemodialysis Patients: A Cohort Study

Rooij, Esther de; Dekker, Friedo W.; Cessie, Saskia le; Hoorn, Ewout J.; Fijter, Johan W. de; Hoogeveen, Ellen K.; Bijlsma, Joost A.; Boekhout, M.; Boer, Walter; Boog, Paul J.M. van der; Büller, HR; Buren, Marjolijn van; Charro, Frank de; Doorenbos, C. J.; Dorpel, Marinus A. van den; Es, Aliev; Fagel, W. J.; Feith, Geert W.; Fijter, C. W. H. De; Frenken, L.A.M.; Grave, Willem S. de; Geelen, J.A.C.A. van; Gerlag, P. G. G.; Gorgels, J. P. M. C.; Huisman, Roel M.; Jager, K. J.; Jie, Kim E.; Koning-Mulder, W.A.H.; Koolen, M. I.; Hovinga, Tkk; Lavrijssen, A. T. J.; Luik, A. J.; Meulen, Jan van der; Parlevliet, K. J.; Raasveld, M. H. M.; Sande, Frank M. van der; Schonck, Marc; Schuurmans, Macé M.; Siegert, C. E. H.; Stegeman, Coen A.; Stevens, Paul E.; Thijssen, J.G.P.; Valentijn, R. M.; G, Vastenburg; Verburgh, Cornelis A.; Vincent, H.H.; Vos, Piet

doi:10.1016/j.xkme.2021.08.013

Cited by 13 publications

(11 citation statements)

References 24 publications

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“…In addition to calcium and phosphate, potassium level disorders are associated with cardiac arrest and mortality in dialysis patients. Predialysis potassium levels of less than 4mmol/L and greater than 6mmol/L were much stronger predictors of mortality [25]. In other studies, the lower limit was 3.5 and the upper limit was 5.5 [25].…”

Section: F Potassiummentioning

confidence: 77%

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Untitled

2023

NRT

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Cardiac arrest represents a significant cause of mortality among patients with End-Stage Renal Disease (ESRD) undergoing renal replacement therapy. This review aimed to synthesize current knowledge on the risk, mechanisms, outcomes and preventative measures for cardiac arrest in this vulnerable population. We conducted a comprehensive literature search in PubMed, identifying both prospective and retrospective studies that reported on cardiac arrest in adult ESRD patients on dialysis. The analysis included variables such as demographics, traditional and non-traditional risk factors and mechanisms of cardiac arrest and prevention strategies. Our review article revealed that cardiovascular disease is a significant burden in ESRD, with cardiac arrest accounting for a significant proportion of mortality. Traditional risk factors included hypertension, diabetes, age, male sex and smoking. Non-traditional risk factors include duration of dialysis treatment, hypotension, inflammation, oxidative stress, mineral bone disorders, electrolyte imbalances, anemia and arrhythmias. Dialysis variables, such as timing, temperature and dialysate composition, were also implicated. We identified several preventative measures, including managing traditional cardiovascular risk factors, modifying dialysis prescriptions, regular cardiac monitoring, consideration of alternative dialysis modalities and medications and optimization of electrolytes and anemia. Our findings underscore the necessity for future research to further understand the intricate relationship between cardiac arrest and hemodialysis, aiming to refine and enhance preventative strategies to improve patient outcomes.

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Section: F Potassiummentioning

confidence: 77%

“…Predialysis potassium levels of less than 4mmol/L and greater than 6mmol/L were much stronger predictors of mortality [25]. In other studies, the lower limit was 3.5 and the upper limit was 5.5 [25]. Meanwhile, a predialysis potassium level of 5.1mmol/L was found to have the lowest sudden cardiac arrest risk [25].…”

Section: F Potassiummentioning

confidence: 86%

Untitled

2023

NRT

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“…In hemodialysis patients, non-adherence links to increased morbidity, mortality, healthcare costs, and burden on the healthcare system [ 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. Hemodialysis patients must maintain safe potassium and phosphate serum levels to avoid fatal arrhythmia and osteodystrophy [ 13 ]. To prevent edema and cardiovascular complications, they must limit fluid intake [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Digital Healthy Diet Literacy and Fear of COVID-19 as Associated with Treatment Adherence and Its Subscales among Hemodialysis Patients: A Multi-Hospital Study

Tran

Duong

et al. 2023

Nutrients

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Treatment adherence (TA) is a critical issue and is under-investigated in hemodialysis patients. A multi-center study was conducted from July 2020 to March 2021 on 972 hemodialysis patients in eight hospitals in Vietnam to explore the factors associated with TA during the COVID-19 pandemic. Data were collected, including socio-demographics, an End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), 12-item short-form health literacy questionnaire (HLS-SF12), 4-item digital healthy diet literacy scale (DDL), 10-item hemodialysis dietary knowledge scale (HDK), 7-item fear of COVID-19 scale (FCoV-19S), and suspected COVID-19 symptoms (S-COVID19-S). Bivariate and multivariate linear regression models were used to explore the associations. Higher DDL scores were associated with higher TA scores (regression coefficient, B, 1.35; 95% confidence interval, 95%CI, 0.59, 2.12; p = 0.001). Higher FCoV-19S scores were associated with lower TA scores (B, −1.78; 95%CI, −3.33, −0.24; p = 0.023). In addition, patients aged 60–85 (B, 24.85; 95%CI, 6.61, 43.11; p = 0.008) with “very or fairly easy” medication payment ability (B, 27.92; 95%CI, 5.89, 44.95; p = 0.013) had higher TA scores. Patients who underwent hemodialysis for ≥5 years had a lower TA score than those who received <5 years of hemodialysis (B, −52.87; 95%CI, −70.46, −35.28; p < 0.001). These findings suggested that DDL and FCoV-19S, among other factors, should be considered in future interventions to improve TA in hemodialysis patients.

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“…For patients with chronic kidney disease (CKD), there exists a U-shaped curve, highlighting increased mortality rates with blood potassium levels below 4.0 mEq/L and above 4.5 mEq/L 1 . Conversely, hypokalemia in hemodialysis (HD) patients is associated with worse outcomes, including mortality and cardiac events 2 . A low pre-dialysis serum potassium (K) level, relative to optimal ranges, poses a significant risk factor for mortality 2 , and post-dialysis hypokalemia increases the incidence of sudden cardiac arrest and cardiac death 3 .…”

Section: Introductionmentioning

confidence: 99%

“…Conversely, hypokalemia in hemodialysis (HD) patients is associated with worse outcomes, including mortality and cardiac events 2 . A low pre-dialysis serum potassium (K) level, relative to optimal ranges, poses a significant risk factor for mortality 2 , and post-dialysis hypokalemia increases the incidence of sudden cardiac arrest and cardiac death 3 . Notably, in HD patients, all-cause mortality risk escalates with rising serum potassium levels, becoming significant at potassium levels exceeding 5.7 mEq/l 4 .…”

Section: Introductionmentioning

confidence: 99%

Lower product of magnesium × potassium is associated with higher mortality in chronic hemodialysis patients: a cohort study

Chen,

Jiang,

Huang

et al. 2023

Sci Rep

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This study aimed to investigate the Mg × K product on the mortality risk of hemodialysis patients with concomitant hypokalemia and lower magnesium levels. This was a prospective observational study of patients in a HD center in southern Taiwan. A total of 444 HD patients were divided into 5 groups by the Mg × K product: group 1, bottom quintile, median Mg × K: 7.87, IQR: 7.03–8.12 (n = 89, age: 64 ± 13 years old); group 2, median Mg × K: 9.37, IQR: 8.97–9.86 (n = 89, age:62 ± 13 years old); group 3, median Mg × K: 10.95, IQR: 10.50–11.26 (n = 89, age:64 ± 13 years old); group 4, median Mg × K: 12.30, IQR: 11.87–12.82 (n = 89, 61 ± 12 years old); and group 5, top quintile, median Mg × K: 14.92, IQR:14.07–16.23 (n = 88, 62 ± 11 years old). The patients were followed up for 2 years to determine the risk of all-cause mortality. Patients with a lower Mg × K product had more comorbidities, malnutrition-inflammation status, and a higher mortality risk. Using multivariable Cox regression analysis, a higher Mg × K [HR, 0.89; 95%CI (0.81–0.98)] was found to be an independent predictor of better survival. HD patients with a lower Mg × K product had more comorbidities, a marked malnutrition-inflammation status, and were associated with long-term mortality. A higher Mg × K value is a favorable survival factor.

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Serum Potassium and Mortality Risk in Hemodialysis Patients: A Cohort Study

Cited by 13 publications

References 24 publications

Untitled

Untitled

Digital Healthy Diet Literacy and Fear of COVID-19 as Associated with Treatment Adherence and Its Subscales among Hemodialysis Patients: A Multi-Hospital Study

Lower product of magnesium × potassium is associated with higher mortality in chronic hemodialysis patients: a cohort study

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