Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
Department of Nephrology, Changwon Fatima Hospital, Changwon, Korea.
Yonsei Med J. 2021 Apr;62(4):315-324. doi: 10.3349/ymj.2021.62.4.315.
To determine seasonal variations in serum potassium levels among hemodialysis patients.
This was a multicenter cohort study of patients whounderwent hemodialysis and were registered in DialysisNet at our four associated general hospitals between January and December 2016. Month-to-month potassium variability was quantified as SD/√{n/(n-1)}, and a non-hierarchical method was used to cluster groups according to potassium trajectories. Seasonal variations in potassium levels were analyzed using a cosinor analysis.
The analysis was performed on 279 patients with a mean potassium level of 5.08±0.58 mmol/L. After clustering, 52.3% (n=146) of patients were included in the moderate group (K, 4.6±0.4 mmol/L) and 47.7% (n=133) in the high group (K, 5.6±0.4 mmol/L). The mean potassium level peaked in January in the moderate group (4.83±0.74 mmol/L) and in August in the high group (5.51±0.70 mmol/L). In the high potassium group, potassium levels were significantly higher in summer than in autumn (<0.001) and spring (=0.007). Month-to-month potassium variability was greater in the high group than in the moderate group (0.59±0.19 mmol/L vs. 0.52±0.21 mmol/L, respectively, =0.012). Compared to patients in the first quartile of potassium variability (≤0.395 mmol/L), those with higher variability (2nd-4th quartiles) were 2.8-4.2 fold more likely to be in the high potassium group.
Different seasonal patterns of serum potassium were identified in the moderate and high potassium groups, with potassium levels being significantly higher in the summer season in the high potassium group and in winter for the moderate potassium group.
确定血液透析患者血清钾水平的季节性变化。
这是一项多中心队列研究，纳入了 2016 年 1 月至 12 月在我们四家附属医院的 DialysisNet 登记的接受血液透析的患者。采用 SD/√{n/(n-1)}量化钾逐月变化的变异程度，并采用非层次聚类方法根据钾轨迹对患者进行分组。采用余弦分析来分析钾水平的季节性变化。
共对 279 例血钾水平平均为 5.08±0.58 mmol/L 的患者进行了分析。聚类后，52.3%（n=146）的患者被纳入中度组（K，4.6±0.4 mmol/L），47.7%（n=133）的患者被纳入高钾组（K，5.6±0.4 mmol/L）。在中度组中，钾水平在 1 月达到峰值（4.83±0.74 mmol/L），在高钾组中在 8 月达到峰值（5.51±0.70 mmol/L）。在高钾组中，夏季的血钾水平明显高于秋季（<0.001）和春季（=0.007）。高钾组的钾逐月变化大于中度组（分别为 0.59±0.19 mmol/L 和 0.52±0.21 mmol/L，=0.012）。与钾变异度较低（第 1 quartile，≤0.395 mmol/L）的患者相比，钾变异度较高（第 2-4 quartile）的患者处于高钾组的可能性是前者的 2.8-4.2 倍。
在中度和高钾组中确定了不同的血清钾季节性模式，高钾组夏季的血钾水平明显升高，而中度钾组则在冬季升高。
