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Hyperkalemia and Hypokalemia in CKD: Prevalence, Risk Factors, and Clinical Outcomes

Sarah Gilligan1, Kalani L Raphael1

  • 1Division of Nephrology, Department of Medicine, University of Utah, Salt Lake City, UT; and Nephrology Section, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT.

Advances in Chronic Kidney Disease
|October 17, 2017
PubMed

Insights

Serum potassium abnormalities, including hyperkalemia and hypokalemia, are common in chronic kidney disease (CKD). Both conditions increase risks for death and cardiovascular disease, with hypokalemia potentially worsening CKD progression.

Area of Science:

  • Nephrology
  • Internal Medicine
  • Cardiology

Background:

  • Serum potassium abnormalities are frequent in patients with chronic kidney disease (CKD).
  • Hyperkalemia is a recognized complication, but hypokalemia occurs with similar prevalence (12%-18%) compared to hyperkalemia (14%-20%).

Purpose of the Study:

  • To review the prevalence and risk factors for hyperkalemia and hypokalemia in CKD patients.
  • To examine the associations between these potassium imbalances and adverse outcomes in CKD.

Main Methods:

  • Literature review of studies on serum potassium levels in CKD.
  • Analysis of factors influencing serum potassium, including CKD severity, medications (RAAS inhibitors, diuretics), and diet.
  • Evaluation of associations with mortality, cardiovascular disease, hospitalization, and CKD progression.

Main Results:

  • Both hyperkalemia and hypokalemia are linked to increased risks of death, cardiovascular disease, and hospitalization.
  • Limited evidence suggests hypokalemia, but not hyperkalemia, may be associated with CKD progression.

Conclusions:

  • Serum potassium monitoring and management are crucial in CKD patients due to similar prevalence of hyperkalemia and hypokalemia.
  • Both conditions carry significant risks, highlighting the need for comprehensive patient assessment and intervention strategies.

Keywords:
Chronic kidney diseaseHyperkalemiaHypokalemiaOutcomesPotassium

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