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Urinary Potassium Excretion and Progression of CKD.


ABSTRACT:

Background and objectives

Data on whether low or high urinary potassium excretion is associated with poor kidney outcome have been conflicting. The aim of this study was to clarify the association between urinary potassium excretion and CKD progression.

Design, setting, participants, & measurements

We investigated the relationship between lower urinary potassium excretion and CKD progression and compared three urinary potassium indices among 1821 patients from the Korean Cohort Study for Outcome in Patients with CKD. Urinary potassium excretion was determined using spot urinary potassium-to-creatinine ratio, spot urinary potassium concentration, and 24-hour urinary potassium excretion. Patients were categorized into four groups according to quartiles of each urinary potassium excretion metric. The study end point was a composite of a ?50% decrease in eGFR from baseline values and ESKD.

Results

During 5326 person-years of follow-up, the primary outcome occurred in 392 (22%) patients. In a multivariable cause-specific hazard model, lower urinary potassium-to-creatinine ratio was associated with higher risk of CKD progression (adjusted hazard ratio, 1.47; 95% confidence interval, 1.01 to 2.12) comparing the lowest quartile with the highest quartile. Sensitivity analyses with other potassium metrics also showed consistent results in 855 patients who completed 24-hour urinary collections: adjusted hazard ratios comparing the lowest quartile with the highest quartile were 3.05 (95% confidence interval, 1.54 to 6.04) for 24-hour urinary potassium excretion, 1.95 (95% confidence interval, 1.05 to 3.62) for spot urinary potassium-to-creatinine ratio, and 3.79 (95% confidence interval, 1.51 to 9.51) for spot urinary potassium concentration.

Conclusions

Low urinary potassium excretion is associated with progression of CKD.

SUBMITTER: Kim HW 

PROVIDER: S-EPMC6419276 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Publications

Urinary Potassium Excretion and Progression of CKD.

Kim Hyung Woo HW   Park Jung Tak JT   Yoo Tae-Hyun TH   Lee Joongyub J   Chung Wookyung W   Lee Kyu-Beck KB   Chae Dong-Wan DW   Ahn Curie C   Kang Shin-Wook SW   Choi Kyu Hun KH   Han Seung Hyeok SH  

Clinical journal of the American Society of Nephrology : CJASN 20190214 3


<h4>Background and objectives</h4>Data on whether low or high urinary potassium excretion is associated with poor kidney outcome have been conflicting. The aim of this study was to clarify the association between urinary potassium excretion and CKD progression.<h4>Design, setting, participants, & measurements</h4>We investigated the relationship between lower urinary potassium excretion and CKD progression and compared three urinary potassium indices among 1821 patients from the Korean Cohort St  ...[more]

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