Does dietary potassium intake associate with hyperkalemia in patients with chronic kidney disease?

2020 ◽  
Author(s):  
Christiane I Ramos ◽  
Ailema González-Ortiz ◽  
Angeles Espinosa-Cuevas ◽  
Carla M Avesani ◽  
Juan Jesus Carrero ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Serum Potassium ◽  
Multivariable Analysis ◽  
Food Groups ◽  
Cross Sectional ◽  
Potassium Intake ◽  
Dietary Potassium ◽  
Dialysis Vintage

Abstract Background Dietary potassium restriction is a strategy to control hyperkalemia in chronic kidney disease (CKD). However, hyperkalemia may result from a combination of clinical conditions. This study aimed to investigate whether dietary potassium or the intake of certain food groups associate with serum potassium in the face of other risk factors. Methods We performed a cross-sectional analysis including a nondialysis-dependent CKD (NDD-CKD) cohort and a hemodialysis (HD) cohort. Dietary potassium intake was assessed by 3-day food records. Underreporters with energy intake lower than resting energy expenditure were excluded. Hyperkalemia was defined as serum potassium >5.0 mEq/L. Results The NDD-CKD cohort included 95 patients {median age 67 [interquartile range (IQR) 55–73] years, 32% with diabetes mellitus (DM), median estimated glomerular filtration rate 23 [IQR 18–29] mL/min/1.73 m2} and the HD cohort included 117 patients [median age 39 (IQR 18–67) years, 50% with DM]. In NDD-CKD, patients with hyperkalemia (36.8%) exhibited lower serum bicarbonate and a tendency for higher serum creatinine, a higher proportion of DM and the use of renin–angiotensin–aldosterone system blockers, but lower use of sodium bicarbonate supplements. No association was found between serum and dietary potassium (r = 0.01; P = 0.98) or selected food groups. Conditions associated with hyperkalemia in multivariable analysis were DM {odds ratio [OR] 3.55 [95% confidence interval (CI) 1.07–11.72]} and metabolic acidosis [OR 4.35 (95% CI 1.37–13.78)]. In HD, patients with hyperkalemia (50.5%) exhibited higher serum creatinine and blood urea nitrogen and lower malnutrition inflammation score and a tendency for higher dialysis vintage and body mass index. No association was found between serum and potassium intake (r = −0.06, P = 0.46) or food groups. DM [OR 4.22 (95% CI 1.31–13.6)] and serum creatinine [OR 1.50 (95% CI 1.24–1.81)] were predictors of hyperkalemia in multivariable analyses. Conclusions Dietary potassium was not associated with serum potassium or hyperkalemia in either NDD-CKD or HD patients. Before restricting dietary potassium, the patient’s intake of potassium should be carefully evaluated and other potential clinical factors related to serum potassium balance should be considered in the management of hyperkalemia in CKD.

scholarly journals MO1055JUDICIOUS DIALYSIS DISCONTINUATION IN CHRONIC KIDNEY DISEASE: LENDING MORE TIME TO ECONOMICALLY BURDENED PATIENTS IN DEVELOPING COUNTRY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Sourabh Sharma ◽  
Neha Sharma ◽  
Kailash Sharma
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Developing Country ◽  
Serum Potassium ◽  
Baseline Serum ◽  
Ckd Stage ◽  
Dialysis Vintage ◽  
Dialysis Discontinuation

Abstract Background and Aims Chronic kidney disease (CKD) is important public health problem owing to its high prevalence, morbidity, mortality and socio-economic burden. Patients with end stage kidney disease need to be on kidney replacement therapy which significantly impacts livelihood. Annual average cost of treatment for patients on dialysis is reported to be USD 3151 in developing country like India. It’s quiet high given per capita income of USD 1670 Method One hundred fifty one CKD Stage 5D patients from Punjab and Rajasthan states, North India were studied in this cross-sectional study. Patients initiated on dialysis within 3 months or protein energy wasting (as per criteria proposed by ISRNM) were excluded. Asymptomatic willing patients, clinically stable for at least 3 months and with pre-dialysis serum Creatinine <6mg/dl, serum potassium <5mg/dl were given a trial for dialysis discontinuation after informed written consent. Biochemical and hemodynamic parameters were measured weekly for 4 weeks and later once monthly. Patients who developed uremic features or rapid rise in serum creatinine were restarted on dialysis. Results Fourteen (9.27%) asymptomatic patients with well controlled blood pressure were discontinued from dialysis. Out of them, thirteen patients were on hemodialysis and one on peritoneal dialysis. Twelve (85.71%) out of them were presumed chronic interstitial nephritis while two (14.28%) were autosomal dominant polycystic kidney disease. Mean age of patients was 52.5 years (SD ±18.14 years). Most patients (11/14) were on three or more anti-hypertensive. Mean dialysis vintage was 8.14 months (range 4-16 months). Most patients were non-compliant to dialysis (Mean frequency once in seven days). Two patients were on once in two week dialysis schedule. Mean 24 hour urine output (calculated over 1 week) was 1500ml. Mean baseline serum creatinine was 4.4 mg/dl (SD ±1.06 mg/dl). Mean pre-dialysis serum potassium was 4.5 mg/dl (SD ±0.42 mg/dl). Post-discontinuation serum creatinine levels has been outlined in figure 1. Mean distance of dialysis centre from residence was 83.43 Km (range 1-240 km). One patient need to be restarted on dialysis at fourth week of dialysis discontinuation. Rest patients remained symptom-free and tolerated well. Conclusion CKD Stage5D patients should be regularly screened for residual renal function. Recovery of renal function could be seen in some (<10%) cases. Dialysis discontinuation in these cases would decrease their financial and stress burden. However, these cases should be monitored closely and followed-up regularly

scholarly journals Risk Factors Associated with Mortality among Chronic Kidney Disease Patients on Regular Hemodialysis Presenting in Emergency Services

2021 ◽  
Vol 2 (1) ◽  
pp. 001-007
Author(s):  
Tirtha Man Shrestha ◽  
Laxman Bhusal ◽  
Ram Prasad Neupane ◽  
Rajan Ghimire ◽  
Pratap Narayan Prasad
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Emergency Room ◽  
Serum Potassium ◽  
Potassium Level ◽  
Emergency Visit ◽  
Survivor Group ◽  
Regular Hemodialysis

Background: With the increasing number of Chronic Kidney Disease (CKD), emergency visit of these patients is also increasing. This study tried to find some of the reasons for which patients with CKD visit the emergency room and the reasons for their mortality. Method: A cross-sectional study was done in the emergency room of Tribhuvan University Teaching Hospital, Kathmandu, Nepal. We conducted this study from 1 May 2018 to 31 October 2018 among the adult CKD patients under regular hemodialysis. We used a convenience sampling method. Three hundred patients were included. We studied the following variables: patient’s age, sex, risk factors, laboratory parameter during the emergency visit (viz. hemoglobin, pH, serum bicarbonate level, and potassium level), emergency hemodialysis, blood transfusion, and clinical outcome during emergency room stay. Result: We enrolled 300 patients in the study. The mean age was 45.04 years in the mortality group and 45.69 years in the survival group 152 (50.7%) of patients had hypertension. Mean hemoglobin was 6.52gm% (SD = 1.93). Mean hemoglobin in survivor and the non-survivor group was 6.59 gm% and 5.58 gm% respectively. Serum creatinine was 1220.87 micromol/l and 1064.01 micromol/l in mortality and survivor group respectively. Likewise, serum potassium was 6.13 mEq/l and 5.74 mEq/l among mortality and survivor groups respectively. Binary logistic regression showed significant association (p <0.05) of anemia, emergency dialysis and presence of sepsis with the mortality. There was significant correlation of presence of comorbidities, anemia, serum creatinine, serum potassium level, and sepsis with mortality. Area under the Receiver Operating Curve to predict mortality among CKD patients was 0.660 for potassium and 0.598 for serum creatinine. Conclusion: Anemia, increased serum creatinine, and hyperkalemia was significantly correlated with mortality in chronic kidney disease and were causes of frequent visits in the emergency room. Therefore, we should address these factors during the management of CKD patients.

scholarly journals Prevalence of Diabetes Mellitus in Patients with Chronic Kidney Disease

2016 ◽  
Vol 4 (1) ◽  
pp. 79-82 ◽  
Author(s):  
Olivera Stojceva-Taneva ◽  
Natasa Eftimovska Otovic ◽  
Borjanka Taneva
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Republic Of Macedonia ◽  
Ckd Stage ◽  
The Republic ◽  
Prevalence Of Diabetes Mellitus

BACKGROUND: Chronic kidney disease (CKD) became a new epidemic of the twentieth and twenty-first centuries. Diabetic nephropathy is one of the leading causes of end-stage renal failure as a result of the diabetes epidemic worldwide.AIM: The aim of our study was to assess the prevalence of CKD in the Republic of Macedonia and its association with diabetes mellitus.MATERIALS AND METHODS: The study was a part of a study conducted in 2006 in terms of screening for early detection of kidney disease. It was a cross-sectional study based on a random sample of patients aged > 20, consecutively consulting their primary physician for any cause. Fifty physicians throughout the country were included in the study. A total of 2637 patients have been analyzed based on integrity data. GFR was estimated using corrected values of serum creatinine and calculating kidney function by the Cockroft & Gault formula, adjusted for body surface using the Gehan & George formula. Patients with estimated glomerular filtration rate (eGFR) less than 60 ml/min were considered as having CKD. Blood pressure, body weight, height, serum creatinine, glucose, hemoglobin, hematocrit, urinalysis and medical history for presence of cardiovascular diseases or diabetes were also assessed.RESULTS: The mean age of the subjects was 45.97 ± 16.55 SD and 17.97% were older than 60. Regarding gender, 44.14% were males. The prevalence of diabetes mellitus was 13.9%. Subjects with CKD (eGFR less than 60 ml/min) were 7.53% of the total. Subjects aged 60 or above, had 20 times higher risk of having CKD (eGFR less than 60 ml/min/1.73 m2). Out of the total group of subjects, 13.9% had diabetes mellitus and they had 3.13 times higher risk of having CKD stage 3-5 (eGFR less than 60 ml/min/1.73 m2) when compared to non-diabetics. The results showed that diabetes was significantly more associated with lower eGFR (less than 60 ml/min/1.73 m2) in younger subjects (age less than 60) compared to older ones (odds ratio 3.29 versus 1.21).CONCLUSION: Our study showed that chronic kidney disease is frequent in the Republic of Macedonia and is associated with older age and diabetes. Diabetes had a significantly stronger association with CKD at younger age.

scholarly journals Hubungan Kadar Kreatinin Serum Dengan Kadar Mineral Pada Pasien Chronic Kidney Disease

2020 ◽  
Vol 7 (2) ◽  
pp. 393-397
Author(s):  
Diah Ayu Kusuma ◽  
Indranila Kustarini Samsuria
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Observational Study ◽  
Serum Creatinine ◽  
Kidney Function ◽  
Medical Records ◽  
Retrospective Observational Study ◽  
Metabolic Processes ◽  
Cross Sectional ◽  
Positive Correlation

Pendahuluan : Chronic Kidney Disease (CKD) merupakan gangguan fungsi ginjal yang irreversible, yaitu kemampuan tubuh gagal untuk mempertahankan metabolisme dan keseimbangan cairan dan elektrolit dan juga mineral. Sebagian besar proses metabolisme memerlukan dan dipengaruhi oleh elektrolit. Konsentrasi elektrolit mineral yang tidak normal dapat menyebabkan banyak gangguan .  Saat fungsi ginjal semakin memburuk menjadi Stadium CKD 4 dan 5, ekskresinya cenderung berkurang dan tidak dapat dikompensasi. Tujuan penelitian ini adalah melihat pengaruh CKD pada mineral yaitu magnesium dan calcium. Metode : Penelitian ini adalah penelitian observasional retrospektif dengan pendekatan belah lintang (cross sectional) dengan melihat rekam medik pada senter tunggal di RSUP Dr. Kariadi Semarang selama periode 1 Januari 2017 – 31 Desember 2018 untuk kemudian dilihat hubungan pengaruh kadar kreatinin serum dengan magnesium dan calcium pada pasien CKD dengan terapi hemodialisis. Hasil dan pembahasan: Terdapat hubungan signifikan positif lemah antara kreatinin serum dengan magnesium (p=0,032, r= 0,327).  Tidak terdapat hubungan antara kreatinin serum dengan kadar kalsium. Simpulan : Dari hasil penelitian dapat disimpulkan bahwa secara statistik terdapat hubungan yang bermakna antara kadar kreatinin serum dengan magnesium pada pasien Chronic Kidney Disease (CKD) dengan terapi hemodialisis. Kata Kunci Kreatinin, mineral, magnesium Chronic Kidney Disease, hemodialisis.   ABSTRACT Introduction: Chronic Kidney Disease (CKD) is an irreversible kidney function disorder, which is the body's ability to fail to maintain metabolism and balance fluid and electrolytes and minerals. Most metabolic processes require and are influenced by electrolytes. Abnormal mineral electrolyte concentrations can cause many disturbances. When kidney function getting worse to stages CKD 4 and 5, the excretion tends to decrease and cannot be compensated. The purpose of this study is to look at the effect of CKD on minerals namely magnesium and calcium. Method: This study was a retrospective observational study with a cross sectional approach by looking at medical records at RSUP Dr. Kariadi Semarang during the period of 1 January 2017 - 31 December 2018 to see the correlation of  influence of serum creatinine levels with magnesium and calcium in CKD patients with hemodialysis therapy. Results and discussion: There was a significantly weak positive correlation between serum creatinine and magnesium (p = 0.032, r = 0.327). There is no correlation between serum creatinine and calcium levels. Conclusion: The results of the study it can be concluded that there is a statistically significant correlation between serum creatinine levels with magnesium in Chronic Kidney Disease (CKD) patients with hemodialysis therapy. Keywords Creatinine, minerals, magnesium Chronic Kidney Disease, hemodialysis.

scholarly journals A retrospective cross-sectional study of the associated factors of hyperuricemia in patients with chronic kidney disease

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052091922
Author(s):  
Li-Ping Guo ◽  
Qin Wang ◽  
Yu Pan ◽  
Yan-Lin Wang ◽  
Ze-Jin Zhang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Serum Uric Acid ◽  
Cross Sectional Study ◽  
Serum Phosphate ◽  
Sectional Study ◽  
Clinical Factors ◽  
Cross Sectional

Objective To investigate the prevalence of hyperuricemia in patients at different stages of chronic kidney disease (CKD) and the association of serum uric acid (SUA) with several clinical factors in a retrospective cross-sectional study of non-dialysis CKD patients at two hospitals in Shanghai, China. Methods The prevalence of hyperuricemia in CKD patients and the association of SUA with other clinical factors were examined using analysis of variance, chi-squared test, multivariate analysis, and other statistical methods. Results A total of 663 CKD patients were enrolled, of which approximately 52% had hyperuricemia. CKD patients with hyperuricemia had lower hemoglobin and estimated glomerular filtration rate (eGFR) levels but higher blood urea nitrogen, serum creatinine, and serum phosphate levels than those without hyperuricemia. Serum uric acid level was positively associated with age, blood urea nitrogen , serum creatinine, cystatin C, and serum phosphate and negatively associated with hemoglobin and eGFR. In addition, CKD patients with anemia and hyperphosphatemia had a higher prevalence of hyperuricemia than those without anemia or hyperphosphatemia. Conclusions The prevalence of hyperuricemia increased with CKD progression supporting the use of urate-lowering treatment for patients with CKD stage 1 to 4.

scholarly journals Interpretation of Erythropoietin and Haemoglobin Levels in Patients with Various Stages of Chronic Kidney Disease

2017 ◽  
Vol 36 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Mirsad Panjeta ◽  
Ismet Tahirović ◽  
Emin Sofić ◽  
Jozo Ćorić ◽  
Amela Dervišević
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Control Group ◽  
Glycoprotein Hormone ◽  
Cross Sectional ◽  
Group Iii ◽  
Spectrophotometric Methods ◽  
Group I ◽  
Blood Haemoglobin

SummaryBackground: The production of erythrocytes is regulated by the hormone erythropoietin (EPO), which maintains the blood haemoglobin (Hb) levels constant under normal conditions. Human EPO is a glycoprotein hormone and its synthesis is controlled by the hypoxia-inducible transcription factor. The aim of this study was to establish EPO and Hb levels in patients with chronic kidney disease (CKD), as well as in control subjects, and to investigate the relationship between these parameters.Methods: This cross-sectional, observational study included 356 subjects with CKD divided into 4 subgroups according to their glomerular filtration rate (GFR). The control group consisted of 206 age and sex matched healthy subjects with GFR rate ≥90 mL/min/1.73 m2. EPO, Hb and serum creatinine levels were determined by using immunochemical and spectrophotometric methods. GFR was determined using the MDRD formula.Results: The CKD patients had significantly lower levels of haemoglobin (p<0.0005) and hematocrit (p<0.0005) compared to control group. Our results showed that Hb levels decreased, whereas serum creatinine increased with the increasing renal failure. The CKD patients in all four groups had significantly lower (p<0.0005) Hb levels, and significantly higher (p<0.0005) creatinine levels compared to the control group. The median EPO in group I and II were significantly higher (p=0.002; p=0.018), while median EPO in group III and IV were significantly lower (p=0.03; p=0.011) compared to the control group.Conclusions: In patients with CKD, GFR positively correlated with Hb and EPO, while the correlation between GFR and serum creatinine was negative.

THE STUDY ON SERUM WITH eGFR IN PATIENTS OF CHRONIC KIDNEY DISEASE

2021 ◽  
pp. 23-25
Author(s):  
Brahmarshi Das ◽  
Narendranath Hait ◽  
Titol Biswas ◽  
Debarshi Jana
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Cross Sectional Study ◽  
Newly Diagnosed ◽  
Creatinine Concentration ◽  
Cross Sectional ◽  
Ckd Stage ◽  
The Mean ◽  
Stage 1

INTRODUCTION: Chronic Kidney Disease (CKD) is dened as a disease characterized by alterations in either kidney structure or function or both for a minimum of 3 months duration. According to the National Kidney Foundation criteria, 1 CKD has been classied into ve stages with stage 1 being the earliest or mildest CKD state and stage 5 being the most severe CKD stage. To stage CKD, it is necessary to estimate the GFR rather than relying on serum creatinine concentration. Glomerular ltration rate (GFR), either directly measured by computing urinary clearance of ltration marker such as inulin or estimated by calculating from different equations using serum creatinine. is the most commonly used parameter to assess kidney function. AIM AND OBJECTIVES: a) Establish relationship between serum CKD and eGFR MATERIAL AND METHOD: A Cross-sectional study on 100 cases of newly diagnosed Chronic Kidney Disease patients and matched control subjects is undertaken to study.100 Patients who are newly diagnosed as CKD are selected after proper initial screening. RESULT AND ANALYSIS: In case, the mean eGFR (mean± s.d.) of patients was 25.1500 ± 11.8929. In control, the mean eGFR (mean± s.d.) of patients was 87.2200 ± 17.8295. Difference of mean eGFR in two groups was statistically signicant (p<0.0001). In case, the mean creatinine (mean± s.d.) of patients was 3.6350 ± 2.4419 mg/dl. In control, the mean creatinine (mean± s.d.) of patients was .9435 ± .1317 mg/dl. Difference of mean creatinine in two groups was statistically signicant (p<0.0001). CONCLUSION: eGFR was strongly associated with CKD that also statistically signicant. The positive correlation was found in eGFR.

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