Hypokalemia in Peritoneal Dialysis: A Systematic Review and Meta-analysis of Prevalence, Treatment, and Outcomes

Rationale & Objective: Hypokalemia is common and potentially life-threatening in patients undergoing peritoneal dialysis (PD). However, the current literature has produced varying results. This study aimed to evaluate the prevalence and adverse outcomes of hypokalemia and the role of potassium supplementation in patients receiving PD. Study Design: Systematic review and meta-analysis of randomized controlled trials and observational studies. Setting & Study Populations: Adults receiving maintenance PD. Selection Criteria for Studies: Studies that investigated the prevalence and adverse outcomes of hypokalemia and the effect of potassium supplementation. Data Extraction: Two independent reviewers evaluated studies for eligibility and extracted relevant data. Analytical Approach: Random effects meta-analysis was conducted to pool hazard ratios (HRs) and 95% CIs for the outcomes of interest. The certainty of findings was rated according to the Grading of Recommendations Assessment, Development and Evaluation criteria. Results: Of 3,632 reports identified, 24 studies involving 60,313 participants met the inclusion criteria. The prevalence of hypokalemia was 37.9% (95% CI, 27.2%-52.7%), 17.7% (95% CI, 12.0%-25.9%), and 4.4% (95% CI, 1.9%-10.2%) in patients with potassium level