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Abstract: TH-PO1031

Instantaneous and Persistent Elevation of Serum Potassium and Progression of CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Wang, Jinwei, Peking University First Hospital, Beijing, Beijing, China
  • Wang, Fang, Peking University First Hospital, Beijing, Beijing, China
  • Zhao, Ming-Hui, Peking University First Hospital, Beijing, Beijing, China

The adverse effect of hyperkalemia on chronic kidney disease (CKD) progression has not been well studied.


The study population was recruited from outpatients of Peking University First Hospital for patients with CKD G1-4 between 2010 and 2020. Those with ≥2 measurements of serum potassium during the first year after recruitment (baseline period) were included in the analysis. Instantaneous hyperkalemia was defined as occurrence of serum potassium≥5.0 mmol/L for once or lasting for < 3 months, while persistent hyperkalemia as repeated occurrence lasting for ≥ 3 months. The initiation of kidney replacement therapy (KRT) was followed after baseline period until death, loss of follow-up or Dec. 31 of 2020. Cox proportional hazards regression model was used to estimate the association between exposure and outcome, while linear mixed effects model to estimate the slope of estimated glomerular filtration rate (eGFR) with interactions between time and hyperkalemia status indicating difference of slope. Two-sided P<0.05 was statistically significant.


A total of 527 patients were included in the analysis, with mean age of 56±16 years and 54.7% of male. CKD stage 1, 2, 3 and 4 accounted for 3.6%, 12.0%, 55.4% and 29.0% of the patients. There were 331, 85 and 111 patients with no, instantaneous and persistent hyperkalemia, respectively. During a mean follow-up of 4.45±3.27 years, 61 events of KRT occurred. Hyperkalemia was associated with higher risk of KRT (Figure 1). After multivariable adjustment, both instantaneous hyperkalemia and persistent hyperkalemia were associated with increased risk of KRT (hazard ratio: 2.43 [95%CI: 1.14-5.18] and 2.86 [95%CI: 1.48-5.54], respectively) and higher rate of eGFR decline (-2.23 and -3.92 versus -1.97 ml/min/1.73m2/year).


Hyperkalemia, especially persistent status, was associated with higher risk of CKD progression among patients with CKD.

Figure 1