Kidney Week

Abstract: FR-PO371

Sex-Specific Relationships between Estimated Potassium Intake and Cardiovascular Outcomes in Patients with CKD: The Fukuoka Kidney Disease Registry Study

Session Information

• Hypertension, CVD, and the Kidneys: Epidemiology
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Suenaga, Tatsuya, Department of Medicine and Clinical Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan

Tatsuya Suenaga, MD

• Tanaka, Shigeru, Department of Medicine and Clinical Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan

Shigeru Tanaka, MD, PhD

• Kitamura, Hiromasa, Department of Internal Medicine, Fukuoka Dental College, Fukuoka, Japan

Hiromasa Kitamura, MD, PhD

• Tsuruya, Kazuhiko, Department of Nephrology, Nara Medical University, Kashihara, Japan

Kazuhiko Tsuruya, MD, PhD

• Kitazono, Takanari, Department of Medicine and Clinical Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan

Takanari Kitazono, MD, PhD

• Nakano, Toshiaki, Department of Medicine and Clinical Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan

Toshiaki Nakano, MD, PhD

Background

Lower potassium intake is associated with an increased risk of cardiovascular disease (CVD) in the general population, and a sex-specific relationship has also been demonstrated. On the other hand, the relationship between potassium intake and CVD risks and its sex-specificity in patients with chronic kidney disease (CKD) has not been adequately investigated. This study aims to investigate the relationship between potassium intake and CVD risk, in addition to examining its sex-specificity in patients with CKD.

Methods

A total of 4,314 Japanese non-dialysis CKD patients aged 18 years or older in the Fukuoka Kidney disease Registry (FKR) Study were prospectively followed for 5 years. Patients were divided into sex-specific quartiles according to estimated potassium intake assessed by the Tanaka formula from spot urine samples. The primary outcome was occurrence of CVD events, defined as a composite of acute myocardial infarction, stable or unstable angina, ischemic or hemorrhagic stroke, peripheral arterial disease, hospitalization for heart failure, and cardiovascular mortality. We estimated the relationship between estimated potassium intake and CVD events using Cox proportional hazards models adjusted for factors related to potential confounding, risk of CVD, and potassium homeostasis.

Results

A total of 431 patients developed the primary outcome during follow-up periods. Patients in quartile 1 (Q1) of the total population had a significantly higher hazard ratio (HR) for CVD events than those in Q4 in the multivariable-adjusted Cox proportional hazards models (fully multivariable-adjusted HR [95% confidence interval {CI}], 1.48 [1.03–2.14]). In addition, there was a significant interaction between estimated potassium intake and CVD events by sex (p for interaction ＜0.01), and in women, patients in Q1 had an even significantly higher HR for CVD events than those in Q4 (multivariable-adjusted HR [95% CI]: men, 1.,2 [0.66–1.60]; women, 3.32 [1.62–6.81]).

Conclusion

Lower estimated potassium intake in patients with CKD was associated with an increased risk for CVD, and the relationship was significant only in women and not in men.