Li S Y, Li G P, Wang L, Duan J Y, Chen W Q, Pan S K, Liu Z S, Liu D W
Department of Nephrology, the First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology of Zhengzhou University, Research Center for Kidney Disease of Henan Province, Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou 450052, China.
Biological Sample Bank, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhonghua Yi Xue Za Zhi. 2021 Nov 16;101(42):3478-3483. doi: 10.3760/cma.j.cn112137-20210630-01477.
To explore the prevalence and related factors of hyperkalemia in patients with diabetic kidney disease (DKD). DKD patients from the Department of Nephrology of the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2020 were selected, and the clinical data of the patients were retrospectively collected. The prevalence of hyperkalemia in DKD patients and the prevalence of hyperkalemia in patients with different age, gender and different stages of chronic kidney disease (CKD) were studied, and the related factors of hyperkalemia were further explored. A total of 1 721 patients with DKD were included, with 1 117 males (64.9%) [mean age: (56±12) years] and 604 females (35.1%) [mean age: (59±12) years]. The blood potassium level of the study population was (4.93±0.77) mmol/L, in which the serum potassium level of male and female was (4.92±0.77) mmol/L and (4.93±0.76) mmol/L, respectively, and the difference was not statistically significant (=0.752). Further grouping by CKD stage, the serum potassium levels of CKD stage 1-5 patients were (4.58±0.52), (4.65±0.47), (4.86±0.59), (5.21±0.79) and (5.61±0.88) mmol/L, respectively, and the difference was statistically significant (=170.701, <0.001). The prevalence of hyperkalemia was 37.0% (636/1 721). The prevalence of mild, moderate and severe hyperkalemia was 17.4%, 10.5% and 9.1%, respectively. There was no significant difference in the prevalence of hyperkalemia between men and women (36.8% vs 37.3%, χ²=0.035, =0.851). The prevalence of hyperkalemia in CKD stage 1-5 patients was 16.3%, 21.2%, 37.6%, 55.2%, 72.5%, respectively, which increased with the severity of CKD (χ²=365.721, <0.001). Multivariate logistic regression showed that estimated glomerular filtration rate (=0.975, 95%: 0.972-0.979), diastolic blood pressure (=0.985, 95%: 0.975-0.994) and serum sodium concentration (=0.972, 95%: 0.945-1.000) were the influencing factors of hyperkalemia in DKD patients. The prevalence of hyperkalemia in DKD patients was 37.0%. Glomerular filtration rate, diastolic blood pressure and serum sodium concentration were the influencing factors. The serum potassium level and the prevalence of hyperkalemia increased with the deterioration of renal function.
探讨糖尿病肾病（DKD）患者高钾血症的患病率及相关因素。选取2012年1月至2020年12月郑州大学第一附属医院肾内科的DKD患者，回顾性收集患者的临床资料。研究DKD患者高钾血症的患病率以及不同年龄、性别和慢性肾脏病（CKD）不同分期患者高钾血症的患病率，并进一步探讨高钾血症的相关因素。共纳入1721例DKD患者，其中男性1117例（64.9%）[平均年龄：（56±12）岁]，女性604例（35.1%）[平均年龄：（59±12）岁]。研究人群的血钾水平为（4.93±0.77）mmol/L，其中男性和女性的血清钾水平分别为（4.92±0.77）mmol/L和（4.93±0.76）mmol/L，差异无统计学意义（=0.752）。按CKD分期进一步分组，CKD 1 - 5期患者的血清钾水平分别为（4.58±0.52）、（4.65±0.47）、（4.86±0.59）、（5.21±0.79）和（5.61±0.88）mmol/L，差异有统计学意义（=170.701，<0.001）。高钾血症的患病率为37.0%（636/1721）。轻度、中度和重度高钾血症的患病率分别为17.4%、10.5%和9.1%。男女高钾血症患病率差异无统计学意义（36.8%对37.3%，χ²=0.035，=0.851）。CKD 1 - 5期患者高钾血症的患病率分别为16.3%、21.2%、37.6%、55.2%、72.5%，随CKD严重程度增加而升高（χ²=365.721，<0.001）。多因素logistic回归显示，估算肾小球滤过率（=0.975，95%可信区间：0.972 - 0.979）、舒张压（=0.985，95%可信区间：0.975 - 0.994）和血清钠浓度（=0.972，95%可信区间：0.945 - 1.000）是DKD患者高钾血症的影响因素。DKD患者高钾血症的患病率为37.0%。肾小球滤过率、舒张压和血清钠浓度是影响因素。血清钾水平和高钾血症患病率随肾功能恶化而升高。
