Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia in Katowice, Francuska Str. 20/24, 40-027, Katowice, Poland.
Department of Internal Diseases and Oncological Chemotherapy, Medical University of Silesia in Katowice, Katowice, Poland.
Eur Geriatr Med. 2021 Oct;12(5):981-987. doi: 10.1007/s41999-021-00484-6. Epub 2021 Apr 8.
Hypokalemia is one of the most common electrolyte disturbances in clinical practice. There are only a few epidemiological studies analyzing the occurrence of hypokalemia in older persons. The aim of the study was to determine the prevalence of hypokalemia in the Polish older population.
Serum potassium concentration was estimated in 4654 participants (2270 females and 2384 males, mean age 76.5 [11.0] years), who participated in the PolSenior study. Hypokalemia was defined as serum potassium concentration below 3.5 mmol/L. Hypokalemia was found in 39 participants (0.84%) and was significantly more frequent among females (28 females = 1.23% and 11 males = 0.46%; p = 0.003). The prevalence of hypokalemia was not related to age. Among 3303 participants suffering from arterial hypertension, 1093 were treated with potassium-losing diuretics.
Hypokalemia was significantly more frequent among hypertensive than normotensive older participants (1.06 vs. 0.30% respectively; p = 0.007) and among hypertensive participants treated with potassium losing diuretics than ones untreated with these drugs (1.96 vs. 0.46% respectively; p < 0.001). In hypertensive participants, the prevalence of hypokalemia did not depend significantly on oral supplementation of potassium (1.92 and 0.98% respectively, NS). None of 81 participants using laxative agents presented hypokalemia.
This study demonstrates that: older age seems not to appear to be a significant risk factor of hypokalemia. Hypokalemia is more often found in the older hypertensive patients treated with potassium losing diuretics, and prevention of diuretic-induced hypokalemia with oral supplementation of potassium seems to be insufficient.
低血钾是临床实践中最常见的电解质紊乱之一。仅有少数几项流行病学研究分析了老年人低钾血症的发生情况。本研究旨在确定波兰老年人群低钾血症的患病率。
在参与 PolSenior 研究的 4654 名参与者(2270 名女性和 2384 名男性,平均年龄 76.5[11.0]岁)中,评估了血清钾浓度。将血清钾浓度<3.5mmol/L 定义为低钾血症。在 39 名参与者(0.84%)中发现了低钾血症,且女性显著更常见(28 名女性为 1.23%,11 名男性为 0.46%;p=0.003)。低钾血症的患病率与年龄无关。在 3303 名患有动脉高血压的参与者中,有 1093 名接受了排钾利尿剂治疗。
与血压正常的老年参与者相比,高血压参与者中低钾血症更常见(分别为 1.06%和 0.30%;p=0.007),且接受排钾利尿剂治疗的高血压参与者比未接受此类药物治疗的参与者更常见(分别为 1.96%和 0.46%;p<0.001)。在高血压参与者中,低钾血症的患病率与口服补钾无明显相关性(分别为 1.92%和 0.98%,无统计学意义)。未发现 81 名使用泻药的参与者出现低钾血症。
本研究表明:老年似乎不是低钾血症的显著危险因素。低钾血症更常见于接受排钾利尿剂治疗的老年高血压患者,且通过口服补钾预防利尿剂引起的低钾血症似乎不够充分。