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Urinary Potassium Excretion and Progression of CKD

Authors
 Hyung Woo Kim  ;  Jung Tak Park  ;  Tae-Hyun Yoo  ;  Joongyub Lee  ;  Wookyung Chung  ;  Kyu-Beck Lee  ;  Dong-Wan Chae  ;  Curie Ahn  ;  Shin-Wook Kang  ;  Kyu Hun Choi  ;  Seung Hyeok Han 
Citation
 CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, Vol.14(3) : 330-340, 2019 
Journal Title
 CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY 
ISSN
 1555-9041 
Issue Date
2019
Keywords
Confidence Intervals ; Disease Progression ; Follow-Up Studies ; Kidney Failure, Chronic ; Potassium ; Proportional Hazards Models ; Renal Insufficiency, Chronic ; Urinary potassium excretion ; chronic kidney disease ; creatinine ; glomerular filtration rate ; kidney
Abstract
BACKGROUND AND OBJECTIVES: Data on whether low or high urinary potassium excretion is associated with poor kidney outcome have been conflicting. The aim of this study was to clarify the association between urinary potassium excretion and CKD progression. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We investigated the relationship between lower urinary potassium excretion and CKD progression and compared three urinary potassium indices among 1821 patients from the Korean Cohort Study for Outcome in Patients with CKD. Urinary potassium excretion was determined using spot urinary potassium-to-creatinine ratio, spot urinary potassium concentration, and 24-hour urinary potassium excretion. Patients were categorized into four groups according to quartiles of each urinary potassium excretion metric. The study end point was a composite of a ≥50% decrease in eGFR from baseline values and ESKD. RESULTS: During 5326 person-years of follow-up, the primary outcome occurred in 392 (22%) patients. In a multivariable cause-specific hazard model, lower urinary potassium-to-creatinine ratio was associated with higher risk of CKD progression (adjusted hazard ratio, 1.47; 95% confidence interval, 1.01 to 2.12) comparing the lowest quartile with the highest quartile. Sensitivity analyses with other potassium metrics also showed consistent results in 855 patients who completed 24-hour urinary collections: adjusted hazard ratios comparing the lowest quartile with the highest quartile were 3.05 (95% confidence interval, 1.54 to 6.04) for 24-hour urinary potassium excretion, 1.95 (95% confidence interval, 1.05 to 3.62) for spot urinary potassium-to-creatinine ratio, and 3.79 (95% confidence interval, 1.51 to 9.51) for spot urinary potassium concentration. CONCLUSIONS: Low urinary potassium excretion is associated with progression of CKD.
Full Text
https://cjasn.asnjournals.org/content/14/3/330.long
DOI
10.2215/CJN.07820618
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Hyung Woo(김형우) ORCID logo https://orcid.org/0000-0002-6305-452X
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169414
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