Kidney Week

Abstract: TH-PO336

Impact of Hypokalemia on Peritonitis in Peritoneal Dialysis Patients: A Multicenter Study

Session Information

• Home Dialysis - I
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

• Choe, Jing Ling, Hospital Sultanah Aminah, Johor Bahru, Johor , Malaysia

Jing Ling Choe,

• Cheong, Xian Pei, Hospital Sultanah Aminah, Johor Bahru, Johor , Malaysia

Xian Pei Cheong,

• Tan, Lay Meng, Hospital Sultanah Aminah, Johor Bahru, Johor , Malaysia

Lay Meng Tan,

• Nur Nadzifah Hanim, Zainal Abidin, Hospital Pakar Sultanah Fatimah, Muar, Johor , Malaysia

Zainal Abidin Nur Nadzifah Hanim,

• Kumar, Agni Nhirmal, Hospital Sultanah Nora Ismail Batu Pahat, Batu Pahat, JOHOR , Malaysia

Agni Nhirmal Kumar,

• Tan, Xue Qi, Hospital Sultanah Aminah, Johor Bahru, Johor , Malaysia

Xue Qi Tan,

• Lee, Leng Soon, Hospital Sultanah Aminah, Johor Bahru, Johor , Malaysia

Leng Soon Lee,

• Fu, Mei Sian, Hospital Sultanah Aminah, Johor Bahru, Johor , Malaysia

Mei Sian Fu,

• Ee, Lik Wee, Hospital Sultanah Aminah, Johor Bahru, Johor , Malaysia

Lik Wee Ee,

• Png, Hon shen, Hospital Sultanah Nora Ismail Batu Pahat, Batu Pahat, JOHOR , Malaysia

Hon shen Png,

• Go, Zher lin, Hospital Pakar Sultanah Fatimah, Muar, Johor , Malaysia

Zher lin Go,

• Ahmad, Nuzaimin H., Hospital Pakar Sultanah Fatimah, Muar, Johor , Malaysia

Nuzaimin H. Ahmad,

• Liu, Wen Jiun, Hospital Sultanah Aminah, Johor Bahru, Johor , Malaysia

Wen Jiun Liu,

Background

The association between peritoneal dialysis (PD) related peritonitis and hypokalemia is not well recognized. We examined their relationship and outcome of peritonitis in three PD centres of the southern region of Malaysia.

Methods

A total of 99 adult patients in Johor state who had undergone Tenchkoff catheter insertion for PD from 1st January 2017 to 31st December 2019 were analysed. Demography, lab results and medical data were obtained from medical records. Serial outpatient readings of serum potassium levels were analysed to define into two groups: hypokalemia (HK) and normokalemia (NK). Subjects with peritonitis will only have preceding 6 months of potassium readings analysed while subjects without peritonitis, have a maximum of 24 months study period. HK was defined as an average serum potassium level <3.5mmol/l, while NK ≥3.5mmol/L. Demographic factors are analysed using chi-square test. Association of potassium status and other related factors with peritonitis were analysed using univariate and multivariate logistic regression.

Results

Among 99 eligible PD patients, mean age (±SD) was 52.68 (±27.99) years old. 59.6% were females and 50.5% were diabetes mellitus. 17 (17.2%) belonged to HK group. Univariate and multivariate logistic regression (table 1) showed only hypokalemia status positively associated with peritonitis: unadjusted odds ratio 3.452 (CI 95% 1.176-10.132, p=0.024) versus adjusted odds ratio 3.224 (CI 95% 1.000–10.395, p=0.050). Among patients who developed peritonitis, HK subjects had lower mean serum albumin level (g/L) than those with NK (25.50±4.06 vs 29.16±5.94). HK subjects had higher CRP levels (mg/L) as compared to those with NK (151.47±94.91 vs 138.29±99.63). Peritonitis-associated catheter removal rate was higher in NK group compared to HK group (45.8% vs 10%, p=0.046).

Conclusion

PD patients with hypokalemia is positively associated with occurrence of peritonitis. Larger sample size and further studies are needed to understand its mechanisms. Correction of hypokalemia is therefore important to prevent such events.

Funding

• Government Support – Non-U.S.