Kidney Week

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

Simon J. Davies, MD

• Zhao, Junhui, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Junhui Zhao,

• Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Brian Bieber,

• Fuller, Douglas S., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Douglas S. Fuller,

• Sloand, James A., Baxter Healthcare Corporation, Deerfield, Illinois, United States

James A. Sloand,

• Vychytil, Andreas, Medical University of Vienna, Vienna, Austria

Andreas Vychytil,

• Kawanishi, Hideki, Tsuchiya General Hospital, Hiroshima, Japan

Hideki Kawanishi,

• Johnson, David W., Princess Alexandra Hospital, Brisbane, Queensland, Australia

David W. Johnson,

• Wang, Angela Yee Moon, University of Hong Kong, Queen Mary Hospital, Hong Kong, HONG KONG, China

Angela Yee Moon Wang,

• Boongird, Sarinya, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Sarinya Boongird,

• Moraes, Thyago Proença de, Pontificia Universidade Catolica do Parana, Curitiba, Brazil

Thyago Proença de Moraes,

• Badve, Sunil V., St. George Hospital, Kogarah, New South Wales, Australia

Sunil V. Badve,

• Perl, Jeffrey, St. Michael's Hospital, Toronto, Ontario, Canada

Jeffrey Perl,

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 – Amgen, AstraZeneca, Baxter Healthcare, Kyowa Hakko Kirin, Hexal AG, Janssen, Keryx, Proteon, Relypsa, Roche, Vifor Fresenius Medical Care Renal Pharma, ERA-EDTA, Japanese Society for PD, Association of German Nephrology Centres, Societies for Nephrology in Germany, Italy, & Spain.