Lower serum potassium associated with increased mortality in dialysis patients: A nationwide prospective observational cohort study in Korea

by Sunhwa Lee, Eunjeong Kang, Kyung Don Yoo, Yunhee Choi, Dong Ki Kim, Kwon Wook Joo, Seung Hee Yang, Yong-Lim Kim, Shin-Wook Kang, Chul Woo Yang, Nam Ho Kim, Yon Su Kim, Hajeong Lee

Background

Abnormal serum potassium concentration has been suggested as a risk factor for mortality in patients undergoing dialysis patients. We investigated the impact of serum potassium levels on survival according to dialysis modality.

Methods

A nationwide, prospective, observational cohort study for end stage renal disease patients has been ongoing in Korea since August 2008. Our analysis included patients whose records contained data regarding serum potassium levels. The relationship between serum potassium and mortality was analyzed using competing risk regression.

Results

A total of 3,230 patients undergoing hemodialysis (HD, 64.3%) or peritoneal dialysis (PD, 35.7%) were included. The serum potassium level was significantly lower (P P = 0.002). HD patients showed a U-shaped survival pattern, suggesting that both lower and higher potassium levels were deleterious, although insignificant. However, in PD patients, only lower serum potassium level (P = 0.048).

Conclusion

Lower serum potassium levels (

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