التفاصيل البيبلوغرافية
| العنوان: |
Dialysate Potassium and Mortality in a Prospective Hemodialysis Cohort |
| المؤلفون: |
Ferrey, Antoney, You, Amy S, Kovesdy, Csaba P, Nakata, Tracy, Veliz, Mary, Nguyen, Danh V, Kalantar-Zadeh, Kamyar, Rhee, Connie M |
| المصدر: |
American Journal of Nephrology, vol 47, iss 6 |
| بيانات النشر: |
eScholarship, University of California |
| سنة النشر: |
2018 |
| المجموعة: |
University of California: eScholarship |
| مصطلحات موضوعية: |
Kidney Disease, Bioengineering, Clinical Research, Assistive Technology, Zero Hunger, Good Health and Well Being, Dialysis Solutions, Female, Humans, Kidney Failure, Chronic, Male, Middle Aged, Potassium, Prospective Studies, Renal Dialysis, Dialysate potassium, Serum potassium, Gradient, Hemodialysis, Mortality, Clinical Sciences, Urology & Nephrology |
| جغرافية الموضوع: |
415 - 423 |
| الوصف: |
BackgroundStudies examining the association of dialysate potassium concentration and mortality in hemodialysis patients show conflicting findings. We hypothesized that low dialysate potassium concentrations are associated with higher mortality, particularly in patients with high pre-dialysis serum potassium concentrations.MethodsWe evaluated 624 hemodialysis patients from the prospective Malnutrition, Diet, and Racial Disparities in Kidney Disease study recruited from 16 outpatient dialysis facilities over 2011-2015 who underwent protocolized collection of dialysis treatment characteristics every 6 months. We examined the association of dialysate potassium concentration, categorized as 1, 2, and 3 mEq/L, with all-cause mortality risk in the -overall cohort, and stratified by pre-dialysis serum potassium (< 5 vs. ≥5 mEq/L) using case-mix adjusted Cox models.ResultsIn baseline analyses, dialysate potassium concentrations of 1mEq/L were associated with higher mortality, whereas concentrations of 3 mEq/L were associated with similar mortality in the overall cohort (reference: 2 mEq/L): adjusted hazard ratios (aHRs; 95% CI) 1.70 (1.01-2.88) and 0.95 (0.64-1.39), respectively. In analyses stratified by serum potassium, baseline dialysate potassium concentrations of 1 mEq/L were associated with higher mortality in patients with serum potassium ≥5 mEq/L but not in those with serum potassium < 5 mEq/L: aHRs (95% CI) 2.87 (1.51-5.46) and 0.74 (0.27-2.07), respectively (p interaction = 0.04). These findings were robust with incremental adjustment for serum potassium, potassium-binding resins, and potassium-modifying medications.ConclusionLow (1 mEq/L) dialysate potassium -concentrations were associated with higher mortality, particularly in hemodialysis patients with high pre-dialysis serum potassium. Further studies are needed to identify therapeutic strategies that mitigate inter-dialytic serum potassium accumulation and subsequent high dialysate serum potassium gradients in this population. |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
unknown |
| العلاقة: |
qt12453584; https://escholarship.org/uc/item/12453584Test |
| الإتاحة: |
https://escholarship.org/uc/item/12453584Test |
| حقوق: |
CC-BY |
| رقم الانضمام: |
edsbas.5452CB4C |
| قاعدة البيانات: |
BASE |
