Abstract: TH-OR096

Low Serum Potassium Is Associated with Indicators of Under-Nutrition and Reduced Residual Kidney Function: Results from the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS)

Session Information

  • Peritoneal Dialysis
    November 02, 2017 | Location: Room 290, Morial Convention Center
    Abstract Time: 06:06 PM - 06:18 PM

Category: Dialysis

  • 608 Peritoneal Dialysis

Authors

  • Davies, Simon J., University Hospital of North Midlands, Stoke-on-Trent, United Kingdom
  • Boongird, Sarinya, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Moraes, Thyago Proença de, Pontificia Universidade Catolica do Parana, Curitiba, Brazil
  • Badve, Sunil V., St. George Hospital, Kogarah, New South Wales, Australia
  • Perl, Jeffrey, St. Michael's Hospital, Toronto, Ontario, Canada
  • Zhao, Junhui, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Fuller, Douglas S., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Sloand, James A., Baxter Healthcare Corporation, Deerfield, Illinois, United States
  • Vychytil, Andreas, Medical University of Vienna, Vienna, Austria
  • Kawanishi, Hideki, Tsuchiya General Hospital, Hiroshima, Japan
  • Johnson, David W., Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Wang, Angela Yee Moon, University of Hong Kong, Queen Mary Hospital, Hong Kong, HONG KONG, China

Group or Team Name

  • On behalf of PDOPPS dialysis prescriptiOn and fluid management working group
Background

Serum potassium <4mmol/L is associated with increased all-cause mortality risk and possibly increased risk of peritonitis in PD patients. We evaluated the relationship between serum potassium (K) and patient characteristics and clinical practices in PDOPPS.

Methods

PDOPPS is a prospective cohort study of PD treatment and outcomes in Australia, Canada, Japan, New Zealand, Thailand, the UK, and the US. Using the most recent value within 8 months of study enrollment, we defined low K as <4 mEq/L. We assessed demographic and clinical associations with low K using logistic regression generalized estimating equations.

Results

Among 2486 incident and prevalent patients analyzed, 69% had K <4 mEq/L. Demographic variables were similar in patients with or without low K. Low K was associated with several indicators of poorer nutritional status, including lower levels of serum phosphorus, creatinine, and albumin, but higher levels of serum bicarbonate. Patients with greater residual kidney function were less likely to have low K. Low K was associated with higher prescribed glucose concentrations and systolic blood pressure.

Conclusion

Low K is associated with indicators of reduced muscle mass and/or protein intake and reduced residual kidney function rather than increased dialytic clearance. Increased blood pressure and prescription of glucose in patients with K≥4 mEq/L group likely reflects their higher oral salt and fluid intake but could reflect increased calorie contribution from dialysate. Clinicians should recognize that lower K levels, even within the normal range, may reflect under-nutrition particularly when associated with reduced residual function and that could contribute to increased mortality risk.

Funding

  • Commercial Support