Health Management Center, Toranomon Hospital, Minato-ku, Japan.
Okinaka Memorial Institute for Medical Research, Minato-ku, Japan.
Nephron. 2023;147(7):417-423. doi: 10.1159/000529424. Epub 2023 Feb 1.
Hypokalemia is associated with an increased risk of chronic kidney disease (CKD) and is a risk factor for mortality. Albuminuria is an early manifestation of CKD. We investigated the association between hypokalemia and the prevalence of albuminuria in a Japanese general population.
We analyzed the data of 18,289 subjects who underwent annual health checkups in 2018. We categorized them into four groups according to their concentration of serum potassium (sK) and performed a multivariate logistic regression analysis to determine the association between hypokalemia and the prevalence of albuminuria in this population. Hypokalemia was defined as having an sK = 3.1-3.5 mEq/L. After dividing the subjects into those with/without renal dysfunction, those with/without hypertension, and those with/without hyperglycemia, we examined the association between hypokalemia and albuminuria in each group.
Compared to the subjects with sK = 4.1-4.5 mEq/L, the subjects with hypokalemia had a significantly high prevalence of albuminuria: multivariable-adjusted odds ratio (OR) = 2.70 (95% confidence interval [CI] 1.84-3.96). The subgroup analyses showed the following multivariable-adjusted ORs (95% CIs) of the subjects: without renal dysfunction, 3.08 (2.00-4.73); with renal dysfunction, 2.05 (0.89-4.69); without hypertension, 2.89 (1.36-6.16); with hypertension, 2.60 (1.67-4.04); without hyperglycemia, 2.49 (1.62-3.84); and with hyperglycemia, 3.55 (1.43-8.79).
Hypokalemia was significantly associated with the high prevalence of albuminuria in general population. Regardless of the presence/absence of renal dysfunction, hypertension, or hyperglycemia, hypokalemia was positively associated with the prevalence of albuminuria, and the associations were significant except for the subjects with renal dysfunction.
低钾血症与慢性肾脏病（CKD）风险增加相关，是死亡的危险因素。蛋白尿是 CKD 的早期表现。我们在日本一般人群中研究了低钾血症与蛋白尿患病率之间的关系。
我们分析了 2018 年接受年度健康检查的 18289 名受试者的数据。根据血清钾（sK）浓度将他们分为四组，并进行多变量逻辑回归分析，以确定该人群中低钾血症与蛋白尿患病率之间的关系。低钾血症定义为 sK = 3.1-3.5 mEq/L。将受试者分为肾功能正常/异常、高血压、高血糖组后，我们在每组中检查低钾血症与蛋白尿之间的关系。
与 sK = 4.1-4.5 mEq/L 的受试者相比，低钾血症受试者的蛋白尿患病率显著较高：多变量校正优势比（OR）= 2.70（95%置信区间[CI] 1.84-3.96）。亚组分析显示，肾功能正常/异常受试者的多变量校正 OR（95% CI）分别为：肾功能正常组 3.08（2.00-4.73），肾功能异常组 2.05（0.89-4.69）；无高血压组 2.89（1.36-6.16），高血压组 2.60（1.67-4.04）；无高血糖组 2.49（1.62-3.84），高血糖组 3.55（1.43-8.79）。
低钾血症与一般人群中蛋白尿患病率显著相关。无论是否存在肾功能异常、高血压或高血糖，低钾血症与蛋白尿患病率呈正相关，除肾功能异常组外，其他组的相关性均有统计学意义。
