Kidney Week

Abstract: PUB203

Serum Potassium Behavior in Patients on Peritoneal Dialysis: A National Cohort Study from the Dominican Republic Health System

Session Information

• Publication Only

Category: Dialysis

• 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

• Hernandez-Ordonez, Sergio O., Macrotech, Santo Domingo, Santo Domingo , Dominican Republic

Sergio O. Hernandez-Ordonez, MD

• Campos, Erwin I., Macrotech, Santo Domingo, Santo Domingo , Dominican Republic

Erwin I. Campos, MD

• Polanco, Elianny, Macrotech, Santo Domingo, Santo Domingo , Dominican Republic

Elianny Polanco, MD

• Lara, Zulma, Macrotech, Santo Domingo, Santo Domingo , Dominican Republic

Zulma Lara, MD

• Cuevas Budhart, Miguel Angel, Instituto Mexicano del Seguro Social Coordinacion de Investigacion en Salud, Ciudad de Mexico, Distrito Federal, Mexico

Miguel Angel Cuevas Budhart, MSc, PhD, RN

• Ramos, Alfonso, Macrotech, Santo Domingo, Santo Domingo , Dominican Republic

Alfonso Ramos, MD

Background

Dyskalemia in peritoneal dialysis (PD) patients is clinically important due to its association with increased morbidity and mortality. The aim of this study is to describe the alterations in serum potassium (K⁺) values in a national cohort of PD patients within the National Health System (SNS) of the Dominican Republic.

Methods

This is a cross-sectional cohort study of 1,080 prevalent PD patients. Biochemical, demographic, and clinical variables were recorded. Simple frequencies were evaluated, with measures of central tendency and dispersion. For differences between groups and due to their heterogeneity, the non-parametric Kruskal-Wallis test was used. To identify differences in means, the X² test was used for categorical variables. The population was stratified into three groups based on the following K⁺ cut-off points: hypokalemia <3.5 mmol/L, hyperkalemia >5.1 mmol/L, and normokalemia for values between these margins.

Results

The cohort mean age was 56yo, 59% where male, 91% hypertensive, 48% DM, 67 use diuretics and 82% CAPD. The mean K⁺ level was 4.7±0.83 mmol/L. The variables with significant differences according to K+ levels were weight (p=0.017), phosphorus (P) (p<0.001), and albumin (p=0.004). The correlation betwen K⁺ with albumin and time on dialysis (r=-0.026, p=0.391) was not significant. However, a positive correlation was found between P and K⁺ levels (r=0.253, p<0.001). The variables that best explain hypokalemia (regression model) are P (β=0.603, p<0.001, 95% CI:0.492-0.740), albumin (β=0.595, p=0.016, 95% CI:0.389-0.909), diuretics (β=0.512, p=0.009, 95% CI:0.309-0.847), and PD modality (β=1.866, p=0.029, 95% CI:1.067-3.264). The variables that best explain hyperkalemia were age (β=1.024, p<0.001, 95% CI:1.024-1.035), P (β=1.361, p<0.001, 95% CI:1.242-1.492), and type of therapy (β=2.367, p<0.001, 95% CI:1.446-3.875)

Conclusion

In our cohort, hyperkalemia is the most common disorder and is associated with higher albumin levels and hyperphosphatemia, indicating a link to greater food intake and better nutritional status. Hypokalemia was observed with hypophosphatemia and hypoalbuminemia. Since diuretic use is associated with hypokalemia, we recommend closer monitoring of potassium levels in patients with residual renal function who use diuretics.

Funding

• Commercial Support – Macrotech