Abstract: FR-PO0270
Serum Potassium and Phosphate Homeostasis in Patients with CKD: The CRIC Study
Session Information
- Bone and Mineral Metabolism: Clinical Epidemiology and Outcomes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Kwon, Alvin Guyun, University of Texas Southwestern Department of Anesthesiology and Pain Management, Dallas, Texas, United States
- He, Jiang, University of Texas Southwestern Department of Anesthesiology and Pain Management, Dallas, Texas, United States
- Geng, Siyi, University of Texas Southwestern Department of Anesthesiology and Pain Management, Dallas, Texas, United States
- Richardson, Sydney L V, Tulane University, New Orleans, Louisiana, United States
- Wright, Layla H., Tulane University, New Orleans, Louisiana, United States
- Lanza, Paola, University of Texas Southwestern Department of Anesthesiology and Pain Management, Dallas, Texas, United States
- McAdams, Meredith C., University of Texas Southwestern Department of Anesthesiology and Pain Management, Dallas, Texas, United States
- Lederer, Eleanor D., University of Texas Southwestern Department of Anesthesiology and Pain Management, Dallas, Texas, United States
- Van Buren, Peter N., University of Texas Southwestern Department of Anesthesiology and Pain Management, Dallas, Texas, United States
- Oygen, Suayp, Tulane University, New Orleans, Louisiana, United States
- Erol, Halil K., Tulane University, New Orleans, Louisiana, United States
- Gorrepati, Geetika, Tulane University, New Orleans, Louisiana, United States
- Batuman, Vecihi, Tulane University, New Orleans, Louisiana, United States
- Moe, Orson W., University of Texas Southwestern Department of Anesthesiology and Pain Management, Dallas, Texas, United States
- Hamm, L. Lee, Tulane University, New Orleans, Louisiana, United States
- Chen, Jing, University of Texas Southwestern Department of Anesthesiology and Pain Management, Dallas, Texas, United States
Background
Increased serum phosphorus is prevalent in CKD and linked to higher mortality risk. Small feeding studies reported that potassium supplementation raises plasma phosphate levels but may decrease fibroblast growth factor 23 (FGF23) without affecting parathyroid hormone (PTH) in non-CKD individuals. This study investigates the associations of serum potassium with serum phosphorus, calcium, FGF23, alkaline phosphatase (ALP), and PTH in a large cohort of CKD patients.
Methods
This analysis included 3,865 participants with CKD from the Chronic Renal Insufficiency Cohort (CRIC) Study after excluding 134 participants with missing data. Linear regression assessed cross-sectional associations of serum potassium with serum phosphorus, calcium, FGF23, ALP, and PTH, adjusting for age, sex, black, center-sites, education, current smoker, calories/day, diabetes status, cardiovascular disease, body mass index, HbA1c, eGFR, use of ACE inhibitors, ARB, and vitamin D, 24-hour urine sodium, and 24-hour urine creatinine.
Results
The average age of participants was 58 years, and the mean eGFR was 44 mL/min/1.73 m^2. After multiple adjustments, serum potassium was significantly and positively associated with serum phosphate and calcium (Table). However, serum potassium was not significantly associated with PTH, FGF23, or ALP levels.
Conclusion
In patients with CKD, elevated circulating potassium is independently linked to higher phosphate and calcium, but not to PTH, FGF23, and ALP, suggesting circulating potassium may be linked to phosphate and calcium metabolism in CKD. Further research is needed to confirm these findings.
Association of a One-SD (0.53 mmol/L) Increase in Serum Potassium with Significant Phosphate-Related Biomarkers
| Outcomes | Multivariable adjusted | |
| β Coefficient (95% CI) | P-value | |
| Serum Phosphate (mg/dL) | 0.09 (0.07, 0.11) | <0.001 |
| Serum Calcium (mg/dL) | 0.05 (0.03, 0.07) | <0.001 |