The aims of this study were to evaluate correlations between serum potassium (S[K]) and uric acid (S[UA]) in hemodialysis patients and to determine whether lower levels of both S[K] and S[UA] were associated with poor long-term prognoses in these patients.
A cohort of 424 maintenance hemodialysis patients (58 ± 13 years of age; 47% male; 39% with diabetes) from a single center were divided into tertiles based on the product of S[K] × S[UA] (K × UA): Group 1: low K × UA: n = 141; Group 2: median K × UA: n = 141; and Group 3: high K × UA: n = 142. The longest observation period was 60 months.
S[K] showed a positive linear correlation with S[UA] (r = 0.33; p < 0.001). In multivariate logistic regression analysis, Group 1 was characterized by hypoalbuminemia (odds ratio [OR] = 0.20, 95% confidence interval (CI) = 0.11–0.35) and lower levels of normalized protein catabolism [nPCR] (OR = 0.10, 95%CI = 0.05–0.22) and phosphate levels (OR = 0.41, 95%CI = 0.33–0.51). In contrast, Group 3 was associated with higher nPCR (OR = 6.07, 95%CI = 2.93–12.50) and albumin levels (OR = 2.12, 95% CI = 2.12–7.00). Compared to the reference (Group 1), the hazard ratio (HR) for long-term mortality was significantly lower in Groups 2 (HR = 0.65, 95%CI = 0.43–0.99) and 3 (HR = 0.56, 95%CI = 0.36–0.89). In multivariate Cox proportional analysis, the risk of mortality decreased by 2% (HR = 0.98; 95%CI = 0.96–0.99) per 1 unit increase in K × UA product.
Hemodialysis patients with lower S[K] and [UA] levels were characterized by hypoalbuminemia and lower nPCR, and they were associated with a long-term mortality risk.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to European Journal of Internal Medicine
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Daily variation in death in patients treated by long-term dialysis: comparison of in-center hemodialysis to peritoneal and home hemodialysis.Am J Kidney Dis. 2013; 61: 96-103
- Serum and dialysate potassium concentrations and survival in hemodialysis patients.Clin J Am Soc Nephrol. 2007; 2: 999-1007
- Electrocardiographic abnormalities in patients receiving hemodialysis.Am Heart J. 1996; 131: 1137-1144
- Hypokalemia is associated with increased mortality rate in chronic hemodialysis patients.Blood Purif. 2011; 32: 254-261
- Reduced glomerular function and prevalence of gout: NHANES 2009–10.PLoS One. 2012; 7: e50046
- Association of incident gout and mortality in dialysis patients.J Am Soc Nephrol. 2008; 19: 2204-2210
- Uric acid levels and all-cause and cardiovascular mortality in the hemodialysis population.Clin J Am Soc Nephrol. 2011; 6: 2470-2477
- Potassium balances in maintenance hemodialysis.Electrolyte Blood Press. 2013; 11: 9-16
- Advanced kidney failure and hyperuricemia.Adv Chronic Kidney Dis. 2012; 19: 419-424
- Equations for normalized protein catabolic rate based on two-point modeling of hemodialysis urea kinetics.J Am Soc Nephrol. 1996; 7: 780-785
- Lower serum potassium combined with lower sodium concentrations predict long-term mortality risk in hemodialysis patients.BMC Nephrol. 2013; 14: 269
- Protein malnutrition and hypoalbuminemia as predictors of vascular events and mortality in ESRD.Am J Kidney Dis. 2004; 43: 61-66
- Low serum uric acid level is a risk factor for death in incident hemodialysis patients.Am J Nephrol. 2009; 29: 79-85
- J-shaped mortality relationship for uric acid in CKD.Am J Kidney Dis. 2006; 48: 761-771
- Serum uric acid levels show a ‘J-shaped’ association with all-cause mortality in haemodialysis patients.Nephrol Dial Transplant. 2004; 19: 457-462
- Monitoring of antioxidant properties of uric acid in humans for a consideration measuring of levels of allantoin in plasma by liquid chromatography.Clin Chim Acta. 2006; 365: 249-256
- Uric acid and long-term outcomes in CKD.Am J Kidney Dis. 2009; 53: 796-803
- Associations of serum uric acid with cardiovascular events and mortality in moderate chronic kidney disease.Nephrol Dial Transplant. 2009; 24: 1260-1266
Published online: August 20, 2015
Accepted: June 28, 2015
Received in revised form: June 19, 2015
Received: May 20, 2015
© 2015 European Federation of Internal Medicine. Published by Elsevier Inc. All rights reserved.