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[Related factors for hyperkalemia and its recurrence in maintenance hemodialysis patients]
Y Y Huang1, J Wang1, N N Wang1
1Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial Hospital, Nanjing 210029, China.
Insights
Hyperkalemia is common in maintenance hemodialysis patients, particularly those with diabetes or undergoing night-time dialysis. Regular serum potassium monitoring is crucial, as high calcium and pre-dialysis potassium levels increase recurrence risk.
Area of Science:
- Nephrology
- Internal Medicine
- Clinical Research
Background:
- Hyperkalemia is a significant complication in patients undergoing maintenance hemodialysis.
- Understanding the prevalence and risk factors for hyperkalemia and its recurrence is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of hyperkalemia and recurrent hyperkalemia in maintenance hemodialysis patients.
- To identify clinical factors associated with the occurrence and recurrence of hyperkalemia.
Main Methods:
- A retrospective study analyzing clinical data of 352 maintenance hemodialysis patients.
- Patients were categorized based on serum potassium levels (normokalemia, hyperkalemia, recurrent hyperkalemia).
- Multivariate logistic regression was used to identify independent risk factors.
Main Results:
- Hyperkalemia was prevalent in 63.4% of patients.
- Independent risk factors for hyperkalemia included night-time dialysis, concurrent diabetes, and frequency of serum potassium testing.
- Recurrent hyperkalemia was associated with higher serum calcium, peak pre-dialysis serum potassium, and testing frequency.
Conclusions:
- Maintenance hemodialysis patients exhibit a high prevalence of hyperkalemia, with increased risk in diabetic patients and those on night-time dialysis.
- Serum calcium and peak pre-dialysis potassium levels are significant risk factors for recurrent hyperkalemia.
- Regular monitoring of serum potassium levels is recommended for this patient population.
Abstract:
Objective: To investigate the prevalence of hyperkalemia and recurrent hyperkalemia in maintenance hemodialysis patients, and identify the related factors. Methods: The general information and clinical data of maintenance hemodialysis patients in the hemodialysis center of the First Affiliated Hospital of Nanjing Medical University from January to December 2020 were collected. According to the level of serum potassium, the patients were divided into normokalemia group and hyperkalemia group. Patients in the hyperkalemia group were further divided into single hyperkalemia group and recurrent hyperkalemia group according to the number of occurrences of hyperkalemia. Then, the prevalence of different serum potassium abnormalities and the related factors were explored. Results: Among the 352 patients included in the final analysis, 129 cases (36.6%) were in the normokalemia group [mean age: (62±15) years, 99 males] and 223 cases (63.4%) were in the hyperkalemia group [mean age: (60±14) years, 153 males]. Multivariate logistic regression analysis demonstrated that, compared with the normokalemia group, night-time dialysis (OR=4.012, 95%CI: 1.519-10.601, P=0.005), concurrent diabetes (OR=1.947, 95%CI: 1.148-3.304, P=0.013) and the number of serum potassium tested before hemodialysis (OR=1.561, 95%CI:1.292-1.885, P<0.001) were independent risk factors for hyperkalemia. Among 223 patients with hyperkalemia, 78 cases (35.0%) were in single hyperkalemia group and 145 cases (65.0%) were in recurrent hyperkalemia group. Multivariate logistic regression analysis demonstrated that, serum calcium (OR=21.885, 95%CI: 3.740-128.077, P=0.001), peak value of serum potassium before hemodialysis (OR=63.157, 95%CI: 25.265-157.876, P<0.001) and the number of serum potassium tested before hemodialysis (OR=1.814, 95%CI: 1.378-2.388, P<0.001) were the independent risk factors for the recurrence of hyperkalemia. Conclusions: The prevalence of hyperkalemia is high in maintenance hemodialysis patients, especially in those with diabetes or night-time dialysis. It is necessary to monitor serum potassium regularly. In addition, high serum calcium and peak value of serum potassium before hemodialysis are related factors for recurrent hyperkalemia.
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