医学
高钾血症
危险系数
血液透析
四分位间距
钾
内科学
置信区间
肾脏疾病
作者
Amélie Bernier-Jean,Germaine Wong,Valeria Saglimbene,Marinella Ruospo,Suetonia C Palmer,Patrizia Natale,Vanessa Garcia-Larsen,David W. Johnson,Marcello Tonelli,Jörgen Hegbrant,Jonathan C Craig,Armando Teixeira-Pinto,Giovanni F M Strippoli
出处
期刊:Clinical Journal of The American Society of Nephrology
[American Society of Nephrology]
日期:2021-12-01
被引量:4
摘要
Dietary potassium restriction in people receiving maintenance hemodialysis is standard practice and is recommended in guidelines, despite a lack of evidence. We aimed to assess the association between dietary potassium intake and mortality and whether hyperkalemia mediates this association.A total of 8043 adults undergoing maintenance hemodialysis in Europe and South America were included in the DIETary intake, death and hospitalization in adults with end-stage kidney disease treated with HemoDialysis (DIET-HD) study. We measured baseline potassium intake from the Global Allergy and Asthma European Network food frequency questionnaire and performed time-to-event and mediation analyses.The median potassium intake at baseline was 3.5 (interquartile range, 2.5-5.0) g/d. During a median follow-up of 4.0 years (25,890 person-years), we observed 2921 (36%) deaths. After adjusting for baseline characteristics, including cardiac disease and food groups, dietary potassium intake was not associated with all-cause mortality (per 1 g/d higher dietary potassium intake: hazard ratio, 1.00; 95% confidence interval [95% CI], 0.95 to 1.05). A mediation analysis showed no association of potassium intake with mortality, either through or independent of serum potassium (hazard ratio, 1.00; 95% CI, 1.00 to 1.00 and hazard ratio, 1.01; 95% CI, 0.96 to 1.06, respectively). Potassium intake was not significantly associated with serum levels (0.03; 95% CI, -0.01 to 0.07 mEq/L per 1 g/d higher dietary potassium intake) or the prevalence of hyperkalemia (≥6.0 mEq/L) at baseline (odds ratio, 1.11; 95% CI, 0.89 to 1.37 per 1 g/d higher dietary potassium intake). Hyperkalemia was associated with cardiovascular death (hazard ratio, 1.23; 95% CI, 1.03 to 1.48).Higher dietary intake of potassium is not associated with hyperkalemia or death in patients treated with hemodialysis.
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