1. Association of Urinary Potassium Excretion with Blood Pressure Variability and Cardiovascular Outcomes in Patients with Pre-Dialysis Chronic Kidney Disease.
- Author
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Suh SH, Song SH, Oh TR, Choi HS, Kim CS, Bae EH, Oh KH, Lee J, Han SH, Kim YH, Chae DW, Ma SK, Kim SW, and On Behalf Of The Korean Cohort Study For Outcomes In Patients With Chronic Kidney Disease Know-Ckd Investigators
- Subjects
- Adult, Aged, Cardiovascular Diseases mortality, Cohort Studies, Creatinine urine, Dialysis methods, Female, Humans, Hypertension epidemiology, Male, Middle Aged, Potassium administration & dosage, Prospective Studies, Renal Insufficiency, Chronic epidemiology, Renal Insufficiency, Chronic mortality, Renal Insufficiency, Chronic physiopathology, Risk Factors, Sodium urine, Blood Pressure, Cardiovascular Diseases epidemiology, Potassium urine, Renal Insufficiency, Chronic urine
- Abstract
Dietary potassium intake is a dilemma in patients with chronic kidney disease (CKD). We investigated the association of urine potassium excretion, a surrogate for dietary potassium intake, with blood pressure variability (BPV) and cardiovascular (CV) outcomes in patients with pre-dialysis CKD. A total of 1860 participants from a cohort of pre-dialysis CKD (KNOW-CKD) patients were divided into the quartiles by spot urine potassium-to-creatinine ratio. The first quartile (26.423 ± 5.731 mmol/gCr) was defined as low urine potassium excretion. Multivariate linear regression analyses revealed an independent association of low urine potassium excretion with high BPV (adjusted β coefficient 1.163, 95% confidence interval 0.424 to 1.901). Cox regression analyses demonstrated that, compared to high urine potassium excretion, low urine potassium excretion is associated with increased risk of CV events (adjusted hazard ratio 2.502, 95% confidence interval 1.162 to 5.387) but not with all-cause mortality. In conclusion, low urine potassium excretion is associated with high BPV and increased risk of CV events in patients with pre-dialysis CKD. The restriction of dietary potassium intake should be individualized in patients with pre-dialysis CKD.
- Published
- 2021
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