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Abstract: SA-PO311

Hyperkalemia Disease Burden and Dialysis Patterns in Chinese Hemodialysis Patients: An Interim Analysis of the Precede-K Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Ni, Zhaohui, Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • Jin, Haijiao, Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • Lu, Renhua, Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • Zhang, Lihong, Department of Nephrology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
  • Yao, Li, Department of Nephrology, The first hospital of China Medical University, Shenyang, China
  • Shao, Guojian, Department of Nephrology, Wenzhou Central Hospital, Wenzhou, Zhejiang, China
  • Zuo, Li, Department of Nephrology, Peking University People's Hospital, Beijing, China
  • Qin, Shuguang, Department of Nephrology, Guangzhou First People's Hospital, Guangzhou, Guangdong, China
  • Zhang, Xinzhou, Department of Nephrology, Shenzhen People's Hospital, Shenzhen, Guangdong, China
  • Zhang, Qinghong, Department of Nephrology, Taihe Hospital, Shiyan, Hubei, China
  • Yu, Weimin, Department of Nephrology, Shanxi Bethune Hospital, Taiyuan, China
  • Luo, Qun, Department of Nephrology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
  • Ren, Yuqing, Department of Nephrology, Yangquan Coal Industry (Group) General Hospital, Yangquan, China
  • Peng, Hui, Department of Nephrology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
  • Xiao, Jie, Department of Nephrology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
  • Yang, Qiongqiong, Department of Nephrology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
  • Chen, Qinkai, Department of Nephrology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
  • Shi, Yifan, Medical Affairs, AstraZeneca Investment China Co, Shanghai, China

Group or Team Name

  • PRECEDE-K study team

Hyperkalemia (HK); common in hemodialysis (HD) patients, is a life-threatening electrolyte imbalance disorder. Studies have shown that long-term control of serum potassium (sK+) in HD patients cannot be achieved However, data on the disease burden and dialysis pattern of HK in Chinese patients on HD is scarce


In this prospective, multicenter, observational cohort study (NCT04799067), dialysis prescription, sK+ and other biochemistry measurements data of HD patients was collected. Data was collected on occurrence of HK, sK+ fluctuation, and dialysis patterns to analyze the disease burden of HK and dialysis patterns in Chinese HD population


In total, 600 patients (67.2% male, 54 years mean age) were enrolled, and 60% of HD patients had heavy disease burden and medical history of HK (sK+>5.0 mmol/L) in last 6 months. At baseline visit, the prevalence of HK was 40%, proportions of sK+>5.5 mmol/L,>6.0 mmol/L and>6.5 mmol/L [17%, 6%, and 3%, respectively]. Dialysate potassium concentration mostly used was 2.0mmol/L (97.7%). Mean HD duration was 4 hours with thrice a week dialysis frequency in 86% of patients. The dialysis adequacy was standard, with average urea reduction ratio of 68% and Kt/V of 1.45. The sK+ fluctuation between pre- and post-dialysis was 1.4 mmol/L, with fluctuation proportions of [0 - < 1], [1 - < 2], [2 - < 3], [≥3] were 24%, 62%, 13% and 1%, respectively. Potassium gradient between serum and dialysate was 2.8 mmol/L, with gradient proportion of [1 - < 2], [2 - < 3], [3 - < 4], [≥4] were 14%, 45%, 36% and 5%, respectively


Prevalence of HK in Chinese HD patients was high. Rebound of sK+ during the inter-dialytic period cannot be controlled under standard dialysis mode. The previous research confirmed that the potassium fluctuation > 1 mmol/l and the potassium gradient ≥ 3 mmol/L is associated with the acute clinical events. Hence, effective potassium-lowering treatments on non-dialysis days to control potassium level and fluctuation requires exploration and further validation

Disease burden of HK