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Abnormal potassium profiles are common in hemodialysis (HD) patients. Hemodialysis therapies maintain potassium mass balance, but different dialytic strategies vary in their ability to assure constancy of normokalemia. We studied the factors associated with serum potassium profiles in HD patients.
Patients were enrolled from one private hospital in Jakarta from September - October 2023. A total of 161 HD patients were examined for factors associated with serum potassium profile. All patients with medical records of at least three months and more than one recorded serum potassium level were extracted. Outpatients undergoing maintenance hemodialysis were stratified into normokalemia, hypokalemia, and hyperkalemia groups based on their pre-dialysis serum potassium levels during the three-month baseline period. Clinically factors and parameters associated with HD were assessed by logistic regression.
There were 99 men and 62 women, with a median age of 57 (46 – 68) years old. Among the therapeutic agents used, Angiotensin receptor blockers (ARB) were used by 60%, 46%, and 55.8% of the patients in the Hypo K, Normo K, and Hyper K groups, respectively. Sodium bicarbonates were used in 39,5% of the patients in Hyper K groups. Low Kt/V per session and high serum phosphate levels were significantly related to the higher serum potassium group patients. There were no significant risk factors for hyperkalemia, including sex, diabetes, calcium, or dialysis frequency by multivariate logistic regression analysis. Age (adjusted odds ratio [OR] 0.979, 95% CI 0.04 – 0.99, p = 0.046) and high levels of serum phosphate (adjusted OR 0.68, 95% CI 0.54 – 0.85, p = 0.001) levels were significant risk factors for hyperkalemia by multivariate logistic regression analysis
Angiotensin receptor blockers (ARB) are not correlated with hyperkalemia however, age with hyperphosphatemia were significantly associated with hyperkalemia in hemodialysis patients.