Huang N Y, Liu Y Y, Yu J W, Xu Y W, Zheng X H, Zhang D H, Ai Z, Wu H S, Diao X W, Ye X Q, Yi C Y, Mao H P, Yang X, Yu X Q, Chen W
Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University/Key Laboratory of Nephrology, National Health Commission/Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China.
Zhonghua Yi Xue Za Zhi. 2021 Nov 16;101(42):3466-3471. doi: 10.3760/cma.j.cn112137-20210802-01710.
To investigate the prevalence and associated factors of hyperkalemia in dialysis patients. Patients underwent hemodialysis (HD) and peritoneal dialysis (PD) from multi-center databases were recruited from January 2017 to December 2019, and those aged ≥18 years and with dialysis duration ≥3 months were included to analyze the prevalence and related factors of hyperkalemia. A total of 12 364 patients were enrolled in the study, and 6 836 cases were men. The average age of the patients was (51±15) years. Among these patients, 4 230 cases underwent HD while 8 134 received PD. Hyperkalemia was detected in 20.7% (2 554/12 364) of the patients while hypokalemia was found in 17.0%(2 102/12 364) of the patients. Multivariate logistic regression showed that HD (=2.25, 95%: 1.54-3.30), diabetes mellitus (DM) (=1.65, 95%: 1.17-2.32), high body mass index (BMI) (=1.06, 95%: 1.03-1.09), high levels of serum albumin (=1.04, 95%: 1.01-1.07) and phosphorus (=3.12, 95%: 2.44-4.00), low levels of serum bicarbonate (=0.89, 95%: 0.87-0.92), triglycerides (=0.76, 95%: 0.68-0.85) and creatinine (=0.95, 95%: 0.90-0.99), usage of angiotensin converting enzyme inhibitor/Angiotensin Ⅱ receptor antagonist (ACEI/ARB, =1.38, 95%: 1.11-1.72) and beta-blocker (=1.32, 95%: 1.07-1.64) were associated with hyperkalemia. Hyperkalemia occurred in 20.7% of the dialysis patients. HD, DM, high BMI, high levels of serum albumin and phosphorus, low levels of serum bicarbonate, triglycerides and creatinine, use of ACEI/ARB were associated with hyperkalemia.
为调查透析患者高钾血症的患病率及相关因素。从多中心数据库中招募了2017年1月至2019年12月期间接受血液透析（HD）和腹膜透析（PD）的患者，纳入年龄≥18岁且透析时间≥3个月的患者，以分析高钾血症的患病率及相关因素。共有12364例患者纳入本研究，其中男性6836例。患者的平均年龄为（51±15）岁。这些患者中，4230例接受HD，8134例接受PD。20.7%（2554/12364）的患者检测到高钾血症，17.0%（2102/12364）的患者发现低钾血症。多因素logistic回归显示，HD（=2.25，95%：1.54 - 3.30）、糖尿病（DM，=1.65，95%：1.17 - 2.32）、高体重指数（BMI，=1.06，95%：1.03 - 1.09）、高血清白蛋白水平（=1.04，95%：1.01 - 1.07）和磷水平（=3.12，95%：2.44 - 4.00）、低血清碳酸氢盐水平（=0.89，95%：0.87 - 0.92）、甘油三酯水平（=0.76，95%：0.68 - 0.85）和肌酐水平（=0.95，95%：0.90 - 0.99）、使用血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂（ACEI/ARB，=1.38，95%：1.11 - 1.72）和β受体阻滞剂（=1.32，95%：1.07 - 1.64）与高钾血症相关。20.7%的透析患者发生高钾血症。HD、DM、高BMI、高血清白蛋白和磷水平、低血清碳酸氢盐、甘油三酯和肌酐水平以及使用ACEI/ARB与高钾血症相关。
