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[Current status of hyperkalemia in dialysis patients in China]

N Y Huang1, Y Y Liu1, J W Yu1

  • 1Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University/Key Laboratory of Nephrology, National Health Commission/Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China.

Zhonghua Yi Xue Za Zhi
|November 15, 2021
PubMed

Insights

Hyperkalemia affects 20.7% of dialysis patients, with hemodialysis and diabetes mellitus being key risk factors. Understanding these associations is crucial for managing electrolyte balance in kidney disease patients.

Area of Science:

  • Nephrology
  • Internal Medicine
  • Clinical Research

Background:

  • Hyperkalemia is a common and serious complication in patients with end-stage renal disease requiring dialysis.
  • Identifying the prevalence and associated factors of hyperkalemia is essential for improving patient outcomes and guiding clinical management.
  • Dialysis modalities, including hemodialysis (HD) and peritoneal dialysis (PD), may influence electrolyte balance and hyperkalemia risk.

Purpose of the Study:

  • To determine the prevalence of hyperkalemia among patients undergoing maintenance hemodialysis and peritoneal dialysis.
  • To investigate the clinical and biochemical factors associated with the occurrence of hyperkalemia in this patient population.

Main Methods:

  • A multi-center study included 12,364 patients (aged ≥18 years, dialysis duration ≥3 months) from January 2017 to December 2019.
  • Data on patient demographics, dialysis modality (HD or PD), comorbidities, and laboratory values were collected.
  • Multivariate logistic regression analysis was employed to identify factors associated with hyperkalemia.

Main Results:

  • The overall prevalence of hyperkalemia was 20.7% (2,554/12,364 patients).
  • Factors significantly associated with hyperkalemia included hemodialysis (OR=2.25), diabetes mellitus (OR=1.65), high BMI (OR=1.06), elevated serum albumin (OR=1.04) and phosphorus (OR=3.12).
  • Low serum bicarbonate (OR=0.89), triglycerides (OR=0.76), and creatinine (OR=0.95), along with the use of ACE inhibitors/ARBs (OR=1.38) and beta-blockers (OR=1.32), were also linked to hyperkalemia.

Conclusions:

  • Hyperkalemia is prevalent in 20.7% of dialysis patients, highlighting a significant clinical challenge.
  • Hemodialysis, diabetes mellitus, higher BMI, elevated serum albumin and phosphorus are associated with increased hyperkalemia risk.
  • Lower serum bicarbonate, triglycerides, creatinine, and use of ACEI/ARBs are also linked to hyperkalemia, necessitating careful monitoring and management.

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