Hyperkalemia in chronic peritoneal dialysis patients

Background. Chronic peritoneal dialysis (PD) patients often develop hypokalemia but less commonly hyperkalemia. Methods. We explored incidence and mechanisms of hyperkalemia in 779 serum samples from 33 patients on PD for 1 − 59 months. Normal serum potassium concentration was defined as 3.5 − 5.1 m...

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Bibliographic Details
Published in:Renal failure 2022-12, Vol.44 (1), p.217-223
Main Authors: Elliott, Andrew B., Soliman, Karim M. M., Ullian, Michael E.
Format: Article
Language:English
Subjects:
Adult
Aged
Angiotensin
Bicarbonates
Creatinine
Female
Humans
Hyperkalemia
Hyperkalemia - blood
Hyperkalemia - epidemiology
Hyperkalemia - etiology
Hypokalemia
Hypokalemia - blood
Hypokalemia - epidemiology
Hypokalemia - etiology
Incidence
Male
Middle Aged
Peritoneal dialysis
Peritoneal Dialysis - adverse effects
Peritoneum
Potassium
Potassium - blood
Potassium chloride
Renin
Retrospective Studies
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Summary:Background. Chronic peritoneal dialysis (PD) patients often develop hypokalemia but less commonly hyperkalemia. Methods. We explored incidence and mechanisms of hyperkalemia in 779 serum samples from 33 patients on PD for 1 − 59 months. Normal serum potassium concentration was defined as 3.5 − 5.1 meq/l. Results. Mean monthly serum potassium concentrations were normal (except for 1 month), but we observed hypokalemia (5.1 meq/l) in 14% of 779 serum samples. Incidence of hyperkalemia did not change over time on PD: Year 1 (15%), Year 2 (11%), Year 3 (19%), Years 4-5 (22%). Hyperkalemia was mostly modest but occasionally extreme [5.2-5.4 meq/l (55%), 5.5-5.7 meq/l (21%), 5.8-6.0 meq/l (10%), >6.0 meq/l (14%)]. Of 31 patients (2 excluded due to brief PD time), 39% displayed hyperkalemia only, 23% displayed hypokalemia only, and the remainder (38%) displayed both or neither. Comparing hypokalemia-only with hyperkalemia-only patients, we found no difference in potassium chloride therapy, medications interrupting the renin-angiotensin system, small-molecule transport status, and renal urea clearance. We compared biochemical parameters from the hypokalemic and hyperkalemic serum samples and observed lower bicarbonate concentrations, higher creatinine concentrations, and higher urea nitrogen concentrations in the hyperkalemic samples (p 
ISSN:0886-022X
1525-6049
DOI:10.1080/0886022X.2022.2032151