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The Relation of Serum Potassium Concentration with Cardiovascular Events and Mortality in Community-Living Individuals.
Tuesday,2017-05-02 12:06 America/Los_Angeles — ecterry
| Title | The Relation of Serum Potassium Concentration with Cardiovascular Events and Mortality in Community-Living Individuals. |
| Publication Type | Journal Article |
| Year of Publication | 2017 |
| Authors | Hughes-Austin, JM, Rifkin, DE, Beben, T, Katz, R, Sarnak, MJ, Deo, R, Hoofnagle, AN, Homma, S, Siscovick, DS, Sotoodehnia, N, Psaty, BM, de Boer, IH, Kestenbaum, B, Shlipak, MG, Ix, JH |
| Journal | Clin J Am Soc Nephrol |
| Volume | 12 |
| Issue | 2 |
| Pagination | 245-252 |
| Date Published | 2017 Feb 07 |
| ISSN | 1555-905X |
| Abstract | <p><b>BACKGROUND AND OBJECTIVES: </b>Hyperkalemia is associated with adverse outcomes in patients with CKD and in hospitalized patients with acute medical conditions. Little is known regarding hyperkalemia, cardiovascular disease (CVD), and mortality in community-living populations. In a pooled analysis of two large observational cohorts, we investigated associations between serum potassium concentrations and CVD events and mortality, and whether potassium-altering medications and eGFR<60 ml/min per 1.73 m(2) modified these associations.</p><p><b>DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: </b>Among 9651 individuals from the Multi-Ethnic Study of Atherosclerosis (MESA) and the Cardiovascular Health Study (CHS), who were free of CVD at baseline (2000-2002 in the MESA and 1989-1993 in the CHS), we investigated associations between serum potassium categories (<3.5, 3.5-3.9, 4.0-4.4, 4.5-4.9, and ≥5.0 mEq/L) and CVD events, mortality, and mortality subtypes (CVD versus non-CVD) using Cox proportional hazards models, adjusting for demographics, time-varying eGFR, traditional CVD risk factors, and use of potassium-altering medications.</p><p><b>RESULTS: </b>Compared with serum potassium concentrations between 4.0 and 4.4 mEq/L, those with concentrations ≥5.0 mEq/L were at higher risk for all-cause mortality (hazard ratio, 1.41; 95% confidence interval, 1.12 to 1.76), CVD death (hazard ratio, 1.50; 95% confidence interval, 1.00 to 2.26), and non-CVD death (hazard ratio, 1.40; 95% confidence interval, 1.07 to 1.83) in fully adjusted models. Associations of serum potassium with these end points differed among diuretic users (Pinteraction<0.02 for all), such that participants who had serum potassium ≥5.0 mEq/L and were concurrently using diuretics were at higher risk of each end point compared with those not using diuretics.</p><p><b>CONCLUSIONS: </b>Serum potassium concentration ≥5.0 mEq/L was associated with all-cause mortality, CVD death, and non-CVD death in community-living individuals; associations were stronger in diuretic users. Whether maintenance of potassium within the normal range may improve clinical outcomes requires future study.</p> |
| DOI | 10.2215/CJN.06290616 |
| Alternate Journal | Clin J Am Soc Nephrol |
| PubMed ID | 28143865 |
| PubMed Central ID | PMC5293337 |
| Grant List | K01 HL122394 / HL / NHLBI NIH HHS / United States |
ePub date:
17/02