Abstract: SA-OR69
Estimated Potassium Intake in Patients with CKD Is Associated with CKD Progression: The Fukuoka Kidney Disease Registry (FKR) Study
Session Information
- Nutritional and Lifestyle Interventions to Promote Health in CKD
November 04, 2023 | Location: Room 109, Pennsylvania Convention Center
Abstract Time: 04:39 PM - 04:48 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Suenaga, Tatsuya, Kyushu Daigaku Igakubu Daigakuin Igakukei Gakufu Daigakuin Igaku Kenkyuin, Fukuoka, Japan
- Tanaka, Shigeru, Kyushu Daigaku Igakubu Daigakuin Igakukei Gakufu Daigakuin Igaku Kenkyuin, Fukuoka, Fukuoka, Japan
- Kitamura, Hiromasa, Kyushu Daigaku Igakubu Daigakuin Igakukei Gakufu Daigakuin Igaku Kenkyuin, Fukuoka, Fukuoka, Japan
- Tsuruya, Kazuhiko, Nara Kenritsu Ika Daigaku, Kashihara, Nara, Japan
- Kitazono, Takanari, Kyushu Daigaku Igakubu Daigakuin Igakukei Gakufu Daigakuin Igaku Kenkyuin, Fukuoka, Fukuoka, Japan
- Nakano, Toshiaki, Kyushu Daigaku Igakubu Daigakuin Igakukei Gakufu Daigakuin Igaku Kenkyuin, Fukuoka, Fukuoka, Japan
Background
Higher potassium intake is associated with a lower odds ratio of chronic kidney disease (CKD) prevalence among the general population. On the other hand, because of the limited evidence examining the benefits and risks of encouraging potassium intake or restricting potassium in patients with CKD, the Kidney Disease Improving Global Outcomes and Kidney Disease Outcomes Quality Initiative guidelines only recommend potassium restriction in hyperkalemic patients with CKD, without making any recommendations regarding potassium intake.
Methods
A total of 4,092 patients aged 18 years or older in Japan were prospectively followed for 5 years using data from the Fukuoka Kidney Disease Registry (FKR) Study. Patients were divided into quartiles according to estimated potassium intake (EPI) levels assessed by the Tanaka formula from spot urine samples (Q1: <1609.5, Q2: 1609.5–1887.2, Q3: 1887.2–2184.4, Q4: >=2184.4 mg/day). The primary outcome was a progression of CKD defined as a composite of a 1.5-fold increase in creatinine from baseline and/or development of end-stage kidney disease. We estimated the relationship between EPI levels and outcomes using Cox proportional hazards models and Fine–Gray models.
Results
A total of 1,407 patients developed primary outcome during follow-up periods with an incidence rate of 89.0 per 1,000 person-years. Patients in Q1 had a significantly higher hazard ratio (HR) for the progression of CKD than those in Q4 in the multivariable-adjusted Cox proportional hazards models (multivariable-adjusted HR [95% confidence interval {CI}], 1.33 [1.10–1.59]). The HR (95% CI) for each 1-SD decrease in EPI levels was 1.13 (1.06–1.22, p <0.05). Similarly, patients in Q1 had a significantly higher subdistribution HR for the progression of CKD than those in Q4 in the multivariable-adjusted Fine–Gray model with all-cause death as a competing risk (subdistribution HR [95% CI], 1.29 [1.08–1.55], p <0.05).
Conclusion
Lower estimated potassium intake is associated with the progression of CKD among patients with CKD. Future studies are needed to determine whether increasing potassium intake has an impact on preserving kidney function.